Effects of a Personal Health Record in Maternity Care: A Stepped-Wedge Trial.

Carola J M Groenen,Joanna Inthout,Marjan J Meinders,Jan A M Kremer,Frank P H A Vandenbussche,Noortje T L Van Duijnhoven

doi:10.3390/ijerph181910343

Abstract

To improve both the active involvement of pregnant women in their maternal health and multidisciplinary collaboration between maternal care professionals, we introduced a personal health record (PHR) in routine maternity care. We studied the effects of this intervention on the percentage of uncomplicated births, women’s perspectives on quality of care, and the collaboration between health care professionals. We performed a stepped-wedge cluster randomized controlled trial with four clusters and 13 maternity health centers (community-based midwife practices and hospitals) in one collaborative area. In total, 7350 pregnant women and 220 health care professionals participated. Uncomplicated births accounted for 51.8% (95% CI 50.1–53.9%) of total births in the control group and 55.0% (CI 53.5–56.5%) of total births in the intervention group (p = 0.289). Estimated means revealed that the differences detected in the stepped-wedge study were due to time and not the intervention. Women’s perspectives on quality of care and collaboration between health care professionals revealed no relevant differences between the control and intervention groups. The introduction of the PHR resulted in no significant effect on the chosen measures of quality of maternal care. The suggested positive effect in the raw data was a local trend which was less visible in the national database, and thus might be related to subtle changes toward an improved collaborative culture in the study region.

Highlights

The aim of the present paper is to present the effects of the introduction of MyPregn@ncy on health outcomes in maternity care
The study was performed in Nijmegen, a single collaborative regional area in the Netherlands with an average of 4000 births a year and over 220 health care professionals involved in maternity care
We introduced a personal health record (PHR) in a maternal care region using a stepped-wedge design

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Personal health records (PHRs) have variable designs and features but are all online applications through which individuals can access, manage, and share their health information in a private, secure, and confidential environment. PHRs are said to empower patients, facilitate communication among health care professionals in the patient’s network, and improve health outcomes [1,2,3,4,5,6,7,8,9]. PHRs show modest but important health effects on women, and promote feelings of control and empowerment [10,11]

Objectives

Methods

Discussion

Conclusion