Avoundjian Tigran, Troszak Lara, Cave Shayna, Shimada Stephanie, McInnes Keith, Midboe Amanda M
Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, USA.
Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington, USA.
JAMIA Open. 2021 Jun 16;4(2):ooab029. doi: 10.1093/jamiaopen/ooab029. eCollection 2021 Apr.
We examined correlates of registration and utilization of the Veteran Health Administration's (VHA) personal health record (PHR), My HealtheVet (MHV), among a national cohort of veterans living with HIV.
Using VHA administrative data, we matched veterans with HIV who registered for MHV in fiscal year 2012-2018 ( = 8589) to 8589 veterans with HIV who did not register for MHV. We compared demographic and geographic characteristics, housing status, comorbidities, and non-VHA care between MHV registrants and nonregistrants to identify correlates of MHV registration. Among registrants, we examined the association between these characteristics and MHV tool use (prescription refill, record download, secure messaging, view labs, and view appointments).
MHV registrants were more likely to be younger, women, White, and to have bipolar disorder, depression, or post-traumatic stress disorder diagnosis than nonregistrants. Having a substance use disorder (SUD) diagnosis or a higher Elixhauser score was associated with lower odds of MHV registration. Among registrants, women were less likely to use prescription refill. Patients who were at risk of homelessness in the past year were less likely to use secure messaging and, along with those who were homeless, were less likely to use view labs and prescription refill. Bipolar disorder and depression were associated with increased secure messaging use. Diagnoses of SUD and alcohol use disorder were both associated with lower rates of prescription refill.
Among veterans living with HIV, we identified significant differences in PHR registration and utilization by race, sex, age, housing status, and diagnosis.
我们研究了在全国感染艾滋病毒退伍军人队列中,退伍军人健康管理局(VHA)的个人健康记录(PHR)即“我的健康退伍军人”(MHV)的注册情况及使用情况的相关因素。
利用VHA行政数据,我们将在2012 - 2018财年注册了MHV的感染艾滋病毒退伍军人(n = 8589)与8589名未注册MHV的感染艾滋病毒退伍军人进行匹配。我们比较了MHV注册者和未注册者之间的人口统计学和地理特征、住房状况、合并症以及非VHA护理情况,以确定MHV注册的相关因素。在注册者中,我们研究了这些特征与MHV工具使用(处方 refill、记录下载、安全消息传递、查看实验室检查结果和查看预约信息)之间的关联。
与未注册者相比,MHV注册者更可能年龄较小、为女性、是白人,并且被诊断患有双相情感障碍、抑郁症或创伤后应激障碍。患有物质使用障碍(SUD)诊断或更高的埃利克斯豪泽评分与MHV注册几率较低相关。在注册者中,女性使用处方 refill的可能性较小。过去一年有无家可归风险的患者使用安全消息传递的可能性较小,并且与无家可归者一起,使用查看实验室检查结果和处方 refill的可能性较小。双相情感障碍和抑郁症与安全消息传递使用增加相关。SUD和酒精使用障碍的诊断均与较低的处方 refill率相关。
在感染艾滋病毒的退伍军人中,我们发现个人健康记录的注册和使用在种族、性别、年龄、住房状况和诊断方面存在显著差异。