The Impact of MyChart (ePHR) Use on the Clinical Outcomes of Behavior-Related Modifiable Health Conditions
Abstract
Background: Obesity, hypertension, type II diabetes mellitus (DM), and hyperlipidemia represent highly prevalent chronic diseases among adult Americans. Each of these diseases are associated with several comorbidities, increased risk of mortality, and collectively place a substantial burden on healthcare resources. Prior scientific studies have linked patient activation with positive lifestyle modifications. Furthermore, patients who are highly engaged in their own care have better outcomes than those who are less involved. Patient portal messaging and ePHR use have theoretical benefits, namely, encouraging patient activation, but current evidence varies on ePHR use and improved clinical outcomes. Objective: This study investigates whether MyChart, an electronic Personal Health Record (ePHR), can be linked to improved clinical outcomes for patients diagnosed with obesity, hypertension, type II diabetes mellitus, and hyperlipidemia. Methods & Design: In this retrospective chart review, we used a two-way ANOVA pairwise comparison analysis to determine whether patients’ health significantly differs between patients who voluntarily use MyChart and those who do not. Our study includes patients aged 18-99 with at least two clinical visits from January 1, 2016 to May 31, 2018, and have a diagnosis of obesity, hypertension, type II diabetes and/or hyperlipidemia. Results: Statistical analysis revealed that there is an elevation of both body mass index (BMI), and low-density lipoprotein cholesterol (LDL) between patients who are “high-users,” compared to “low- users” of MyChart ePHR, as determined by number of messages sent to their providers (p < 0.05).
These differences, however, are unlikely clinically significant. There is no statistical difference in hypertensive patients, or diabetic patients between the high-use and low-use groups. Conclusion: Overall, there is inconclusive evidence that ePHR use is associated with better measured health outcomes in Type II Diabetes Mellitus, hypertension, hyperlipidemia, and/or obesity.