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      Usefulness and Usability of a Personal Health Record and Survivorship Care Plan for Colorectal Cancer Survivors: Survey Study

      research-article
      , DrPH, MLIS 1 , 2 , , , MD 3 , , MD, MAS 1 , 4 , 5
      (Reviewer), (Reviewer), (Reviewer)
      JMIR Cancer
      JMIR Publications
      personal health record, colorectal cancer, survivorship, digital health, digital medicine

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          Abstract

          Background

          As a result of improvements in cancer screening, treatment, and supportive care, nearly two-thirds of individuals diagnosed with colorectal cancer (CRC) live for 5 years after diagnosis. An ever-increasing population of CRC survivors creates a need for effective survivorship care to help manage and mitigate the impact of CRC and its treatment. Personal health records (PHRs) and survivorship care plans provide a means of supporting the long-term care of cancer survivors.

          Objective

          The purpose of this study is to characterize the usefulness of a CRC PHR and survivorship care plan and to describe the usability of these technologies in a population of CRC survivors. To our knowledge, this is the first study to assess a PHR and survivorship care plan specifically targeting CRC survivors.

          Methods

          Twenty-two patients with CRC were recruited from surgery clinics of an academic medical center and Veterans Affairs hospital in Indianapolis and provided access to an online Colorectal Cancer Survivor’s Personal Health Record (CRCS-PHR). Survey data were collected to characterize the usefulness of the CRCS-PHR and describe its usability in a population of CRC survivors. CRC survivors were surveyed 6 months after being provided online access. Means and proportions were used to describe the usefulness and ease of using the CRC website. Open-ended questions were qualitatively coded using the constant comparative method.

          Results

          CRC survivors perceived features related to their health care (ie, summary of cancer treatment history, follow-up care schedule, description of side effects, and list of community resources) to be more useful than communication features (ie, creating online relationships with family members or caregivers, communicating with doctor, and secure messages). CRC survivors typically described utilizing traditional channels (eg, via telephone or in person) to communicate with their health care provider. Participants had overall positive perceptions with respect to ease of use and overall satisfaction. Major challenges experienced by participants included barriers to system log-in, lack of computer literacy or experience, and difficulty entering their patient information.

          Conclusions

          For CRC, survivors may find the greater value in a PHR’s medical content than the communication functions, which they have available elsewhere. These findings regarding the usefulness and usability of a PHR for the management of CRC survivorship provide valuable insights into how best to tailor these technologies to patients’ needs. These findings can inform future design and development of PHRs for purposes of both cancer and chronic disease management.

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          Most cited references24

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          Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors.

          In this article, the incidence, mortality, and survival rates for colorectal cancer are reviewed, with attention paid to regional variations and changes over time. A concise overview of known risk factors associated with colorectal cancer is provided, including familial and hereditary factors, as well as environmental lifestyle-related risk factors such as physical inactivity, obesity, smoking, and alcohol consumption.
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            Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption.

            Recently there has been a remarkable upsurge in activity surrounding the adoption of personal health record (PHR) systems for patients and consumers. The biomedical literature does not yet adequately describe the potential capabilities and utility of PHR systems. In addition, the lack of a proven business case for widespread deployment hinders PHR adoption. In a 2005 working symposium, the American Medical Informatics Association's College of Medical Informatics discussed the issues surrounding personal health record systems and developed recommendations for PHR-promoting activities. Personal health record systems are more than just static repositories for patient data; they combine data, knowledge, and software tools, which help patients to become active participants in their own care. When PHRs are integrated with electronic health record systems, they provide greater benefits than would stand-alone systems for consumers. This paper summarizes the College Symposium discussions on PHR systems and provides definitions, system characteristics, technical architectures, benefits, barriers to adoption, and strategies for increasing adoption.
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              Data analysis in qualitative research

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                Author and article information

                Contributors
                Journal
                JMIR Cancer
                JMIR Cancer
                JC
                JMIR Cancer
                JMIR Publications (Toronto, Canada )
                2369-1999
                Jul-Dec 2019
                20 August 2019
                : 5
                : 2
                : e10692
                Affiliations
                [1 ] VA Health Services Research and Development Center for Health Information & Communication Richard L Roudebush VA Medical Center Indianapolis, IN United States
                [2 ] Department of Health Policy & Management Fairbanks School of Public Health Indiana University Indianapolis, IN United States
                [3 ] Department of Surgery School of Medicine Indiana University Indianapolis, IN United States
                [4 ] Division of General Internal Medicine and Geriatrics School of Medicine Indiana University Indianapolis, IN United States
                [5 ] Center for Health Services Research Regenstrief Institute Indianapolis, IN United States
                Author notes
                Corresponding Author: Will L Tarver willi.tarver@ 123456va.gov
                Author information
                http://orcid.org/0000-0001-7667-5758
                http://orcid.org/0000-0003-0213-876X
                http://orcid.org/0000-0003-3637-6950
                Article
                v5i2e10692
                10.2196/10692
                6719487
                31432780
                1195a73b-6366-4296-88cc-9c16d9a4f029
                ©Will L Tarver, Bruce W Robb, David A Haggstrom. Originally published in JMIR Cancer (http://cancer.jmir.org), 20.08.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on http://cancer.jmir.org/.as well as this copyright and license information must be included.

                History
                : 11 June 2018
                : 3 September 2018
                : 30 January 2019
                : 18 February 2019
                Categories
                Original Paper
                Original Paper

                personal health record,colorectal cancer,survivorship,digital health,digital medicine

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