Impact of a patient-centered, computer-based health information/support system

Background: Consumer health information systems potentially improve a patie nt's quality of life and activate patient self-care. Objectives: Test a computerized system (CHESS: Comprehensive Health Enhance ment Support System), which, in this application, provided HIV-positive pat ients with information, decision support, and connections to experts and ot her patients. Would patients given in-home access to computers use the syst em, improve their quality of life, reduce health-risk behaviors, and use me dical services more efficiently! Research Randomized controlled trial: CHESS computers in experimental subje cts' homes in Design: Madison or Milwaukee, Wisconsin, for 3 or 6 months; controls receiv ed no intervention. Subjects were compensated for self-report surveys compl eted before, during, and after CHESS installation. Subjects: Of 204 HIV-positive patients recruited (90% male, 84% white, aver age education some college, and 65% experiencing HIV-related symptoms), 90% completed the study. Measures: Self-reports of quality of life and frequency and duration of use of medical services. Results: CHESS was used daily with little difference between demographic su bgroups. While CHESS was in the home, its users reported quality-of-life im provements: active life, negative emotions, cognitive function, social supp ort, and participation in health care. They also reported spending less tim e during ambulatory care visits, making more phone calls to providers, and experiencing fewer and shorter hospitalizations. Conclusions: A computer-based personal health support system can improve a patient's quality of life and promote more efficient use of health care.