Patient reminders and notifications are effective at helping people reach health goals. They alert people to schedule medical visits and screenings, remind people how to take complex medical regimens, and provide a liaison between patients, providers, and the health care system. Most studies of reminders have focused on a single health care need or condition and have used a single route, such as postal mail or the telephone. We lack knowledge about reminder and notification systems that incorporate the breadth of patients' multiple chronic and preventive health care needs. We know little about how to incorporate reminders and notifications into newer forms of communication with patients including text messaging, mobile phone applications, and patient websites linked to electronic health records. When combined with fully functional electronic health records, new communication technologies are an opportunity to contact patients more often with a more comprehensive set of reminders and notifications than previously possible. Despite their promise, reminders and notifications, if poorly designed, can overwhelm or annoy patients and undermine their effectiveness. In this project, we will first establish the needs and preferences o patients for notifications and reminders through an understanding of patient workflow models, user requirements, and contextual factors. Next, we will clarify core design elements through building and testing a prototype of a patient-controlled health reminder and notification system and establish feasibility of integration with the patient-centered medical home. To address the diversity of user needs and preferences, we will focus on two common populations with different chronic and preventive care issues who would benefit from effective reminder and notification systems: mothers with children under age 12 who have asthma, the most common chronic condition among children; and individuals with diabetes who have multiple other chronic conditions. We will perform our study among members of Group Health Cooperative (Group Health), a large, integrated health care system with a patient website and mobile application used by more than 65 percent of the enrolled population to engage in care through an electronic health record. Group Health's implementation of a patient-centered medical home model and experience interacting with patients and families through the electronic health record make it an ideal environment for this work. The medical home and electronic medical records are steadily permeating health care systems across the country. This work will provide the key design elements for reminder and notification systems that could broadly inform care redesign. The results of this work will be informative to health care organizations, health information technology developers, and health care researchers.

R01HS021590

2013-08-01

2017-05-31