Computer-Based Patient Education Resources and Instruction

  • Cezanne Garcia
Part of the Health Informatics book series (HI)


A new adult patient calls to schedule a first-time appointment for a physical exam. A “new patient” packet is mailed and includes descriptive and contact information about the clinic and care team, including the clinic’s Web site, a suggested preview of three health Web sites, and a patient-clinician e-mail address for questions and inquiries. Two days before the patient’s visit, a reminder call about the date and time of the appointment is communicated via an interactive voice response system.


Health Information Patient Education Interactive Voice Response System Patient Education Material Online Support Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Center for the Advancement of Health. Health behavior change in managed care status report. Washington DC, 2000.Google Scholar
  2. 2.
    Crosson K, Nakamura RB, Simmons R. Health People 2010 Objectives for the Health Care Setting. Health Promotion Practice 1:3:243–244; 2000.CrossRefGoogle Scholar
  3. 3.
    Findham JE, Wertheimer AI. Predictors of patient satisfaction in a health maintenance organization. Journal of Health Care Marketing 6:6–11, 1986.Google Scholar
  4. 4.
    Robbins JA, Bertakis KD, Helms LJ, Azari R, Callahan EJ, Creten DA. The influence of physician practice behaviors on patient satisfaction. Family Medicine 26:17–20, 1993.Google Scholar
  5. 5.
    Schauffler HH, Rodriguez T, Milstein A. Health education and patient satisfaction. The Journal of Family Practice, 42:1:62–68, 1996.PubMedGoogle Scholar
  6. 6.
    Haynes, RB. A Critical review of the ‘determinants’ of patient compliance with therapeutic regimens, in: D.L. Sackett and R. B. Haynes eds., Compliance with therapeutic regimens. Johns Hopkins University Press, Baltimore, MD, 26–39, 1976.Google Scholar
  7. 7.
    Marquis MS, Davies Ar, Ware JE. Patient satisfaction and change in medical care provider: a longitudinal study. Medical Care 21:821–830, 1983.PubMedCrossRefGoogle Scholar
  8. 8.
    Herzlinger RE. The failed revolution in health care-the role of management. Harvard Business Review 99:95–103, 1989.Google Scholar
  9. 9.
    Singh J. A multifaceted topology of patient satisfaction with a hospital. Journal of Health Care Marketing 10:8–21; 1990.PubMedGoogle Scholar
  10. 10.
    Ware JE, Davies AR. Behavioral consequences of consumer dissatisfaction with medical care. Evaluation and Program Planning. 6:301–307; 1083.Google Scholar
  11. 11.
    Meterko, M. Overview: the evolution of customer feedback in health care. Journal of Quality Improvement. 22:5:307–310, 1999.Google Scholar
  12. 12.
    National Center for Health Statistics. Health U.S. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention 1999.Google Scholar
  13. 13.
    Vickery DM, Glaszewski TJ, Wright EC, Kalmer H. The effect of self-care interventions on the use of medical service within a Medicare population. Medical Care. 26:580–588, 1988.PubMedCrossRefGoogle Scholar
  14. 14.
    National Committee for Quality Assurance, accessed July 2000, 1999.Google Scholar
  15. 15.
    US Government Accounting Office. Consumer Health Informatics: Emerging Issues. Washington, DC: US Government Accounting Office; 1996. Publication GAO/AIMD-96-86.Google Scholar
  16. 16.
    Harris poll #76, December 22,1999. Online population growth surges to 56% of all adults. accessed June 2000.Google Scholar
  17. 17.
    FIND/SVP Inc. The 1997 American Internet User Survey. New York, NY: Cyber Dialogue, Inc. 1997.Google Scholar
  18. 18.
    CyberDialogue. Impacts of the internet on the doctor-patient relationship; the rise of the internet health consumer., Accessed August 2000, 1999.Google Scholar
  19. 19.
    National Library of Medicine Publication, Gratefully Yours. 1998; Mar/Apr:5. Bethesda, MD.Google Scholar
  20. 20.
    National Managed Health Care Congress (NMHCC). Results of latest managed-care IT study from Microsoft, NMHCC, Dorenfest and Compaq shows internet is key to addressing IT challenges. accessed June 2000.Google Scholar
  21. 21.
    Staggers N, Thompson CR, Happ B, Thomas CR. An operational model for patient-centered informatics. Computers in Nursing 1999 Nov–Dec; 17(6): 278–285.PubMedGoogle Scholar
  22. 22.
    Nahm, R, Poston, I. Measurement of the effects of an integrated point-of-care computer system on quality of nursing documentation and patient satisfaction. Computers in Nursing 18,5, 220–229, 2000.PubMedGoogle Scholar
  23. 23.
    Holzmer WI, Henry SG. Computer supported vs manually generated nursing care plans; a comparison of patient problems, nursing interventions, and AIDS patient outcomes. Computers in Nursing, 10: 199–124, 1992.Google Scholar
  24. 24.
    Hendrickson G, Kouner CT, Kinckman JR, Finkler SA. Implementation of a variety of computerized bedside nursing information systems in 17 New Jersey Hospitals. Computers in Nursing, 13: 96–102, 1995.PubMedGoogle Scholar
  25. 25.
    Doak CC, Doak LG, Root JH. Teaching patients with low literacy skills. 2nd ed. Philadelphia, JB Lippincott-Raven Publishers, 1996.Google Scholar
  26. 26.
    Kreuter MW, Farrell D, Olevitch L, Brennan L. Tailoring Health Messages: Customizing Communication with Computer Technology. Earlbaum Publishers, N.J. 2000.Google Scholar
  27. 27.
    Wise PH, Pietroni RG, Bhatt VB, Bond CS, Hirst S, Hooker RJ. Development and evaluation of a novel patient information system. J R Soc Med 89: 557–560, 1996.PubMedGoogle Scholar
  28. 28.
    Glascoe FP, Oberklaid F, Dworkin PH, Trimm F. Brief approaches to educating patients and parents in primary care. Pediatrics 101:1068, 1998.CrossRefGoogle Scholar
  29. 29.
    Anderson JE, Morrell DC, Avery AJ, Watkins CJ. Evaluation of a patient education manual. British Medical Journal 281:924–925, 1980.PubMedCrossRefGoogle Scholar
  30. 30.
    Casey R, McMahon F, McCormick MC. Fever therapy: educational intervention for parents. Pediatrics 73:600–603, 1984.PubMedGoogle Scholar
  31. 31.
    Roberts CR, Imrey PB, Turner JD. Reducing physician visits for colds through consumer education. JAMA 250:1986–1989, 1993.CrossRefGoogle Scholar
  32. 32.
    Bhopal RS, Gilmour WH, Fallon CW, Bhopal JS, Hamilton I. Evaluation of a practice information leaflet. Family Practice 7:132–137, 1990.PubMedCrossRefGoogle Scholar
  33. 32.
    Chamorro, T, and Apelbaum, J. Informed consent: nursing issues and ethical dilemmas. Oncology Nursing Forum 15(6):803–808, 1998.Google Scholar
  34. 33.
    Feste C, Anderson RM. Empowerment: from philosophy to practice. Patient Education Counseling 26:139–144, 1995.CrossRefGoogle Scholar
  35. 33.
    McVea K, Venugopal M, Crabtree B: The organization and distribution of patient education materials in family medicine practices. Journal of Family Practice 49(4), 319–326, 2000.PubMedGoogle Scholar
  36. 34.
    Bandura, A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ, Prentice-Hall, 1986.Google Scholar
  37. 35.
    Prochaska, JO, DiClemente CC, Norcross JC. In search of how people change, applications to addictive behaviors. American Psychology 47:1102–1114,1992.CrossRefGoogle Scholar
  38. 36.
    Science Panel on Interactive Communication and Health. Wired for Health and Weil-Being: the Emergence of Interactive Health Communication. Washington, DC: US Department of Health and Human Services, US Government Printing Office, April 1999.Google Scholar
  39. 38.
    Nielsen, E., and Sheppard, M.S. Television as a patient education tool: a review of its effectiveness. Patient Education and Counseling 11(1):3–16, Feb 1988.PubMedCrossRefGoogle Scholar
  40. 39.
    Alkhateeb W, Lukeroth CJ, Riggs M. A comparison of three educational techniques used in a venereal disease clinic. Public Health Rep. 1975 Mar–Apr; 90(2):159–164.PubMedGoogle Scholar
  41. 40.
    Rosenthal, AR, Zimmerman, JF, and Tanner, J. Educating the glaucoma patient. British Journal of Ophthalmology 67:814–817, 1983.PubMedCrossRefGoogle Scholar
  42. 41.
    Marshall WR, Rothenberger LA, Bunnell SL. The efficacy of personalized audiovisual patient-education materials. Journal of Family Practice 1984 Nov;19(5):659–663.PubMedGoogle Scholar
  43. 42.
    Mazzuca SA, Moorman NH, Wheeler ML, Norton JA, Fineberg NS, Vinicor F, Cohen SJ, Clark CM Jr. The diabetes education study: a controlled trial of the effects of diabetes patient education. Diabetes Care. 1986 Jan–Feb; 9(1):1–10.PubMedCrossRefGoogle Scholar
  44. 43.
    Lewis, Deborah. Computer-based approaches to patient education: a review of the literature. Journal of the American Medical Informatics Association 5:4:272–282, 1999.CrossRefGoogle Scholar
  45. 44.
    AHCPR (Agency for Health Care Policy and Research). Consumer health informatics and patient decision-making. Final report. Rockville, MD: US Department of Health and Human Services, Agency for Health Care and Policy Research AHCPR publication 98-N001, 1997.Google Scholar
  46. 45.
    Griest JH, Kelin MH, Van Cura LJ. A computer interview for psychiatric patient target symptoms. Archives of General Psychiatry 29:247–253, 1973.CrossRefGoogle Scholar
  47. 46.
    Millstein SSG, Irwin CE Jr. Acceptability of computer-acquired sexual histories in adolescent girls. Journal of Pediatrics 103(5) 815–819, 1983.PubMedCrossRefGoogle Scholar
  48. 47.
    Paperny DM. Computerized health assessment and education for adolescent HIV and STD prevention in health care settings and schools. Health Education and Behavior 24(1) 54–70, 1997.PubMedCrossRefGoogle Scholar
  49. 48.
    Erdman, HP, Klein MH, Greist JH. Direct patient computer interviewing. Journal of Consulting Clinical Psychology. 53:760–773, 1985.CrossRefGoogle Scholar
  50. 49.
    Kieschnick T, Adler, L, Jimison H. 1996 Health Informatics Directory, Williams & Wilkins, 1996.Google Scholar
  51. 50.
    Cornelius L, Beauregard K, Cohen J. Usual sources of medical care and their characteristics. Agency for Health Care Policy and Research Pub. 91-0042, Rockville, MD: Public Health Service 1991.Google Scholar
  52. 51.
    Ferguson T. Health online. How to find health information, support groups, and self-help communities in cyberspace. Reading, MA: Addison-Wesley Publishing Company; 1996.Google Scholar
  53. 52.
    Klemm P, Reppert K, Visich L. A nontraditional cancer support group: the Internet. Computers in Nursing 16: 31–36, 1998.PubMedGoogle Scholar
  54. 53.
    King S. Analysis of electronic support groups for recovering addicts (online). Available at: Accessed: July, 2000.Google Scholar
  55. 54.
    Fernsler JI, Manchester LJ. Evaluation of a computer based cancer support network. Cancer Practice 5:46–51, 1997.PubMedGoogle Scholar
  56. 55.
    Winzelberg A. The analysis of an electronic support group for individuals with eating disorders. Computers in Human Behavior 13:393–407, 1997.CrossRefGoogle Scholar
  57. 56.
    Finn J. An exploration of helping processes in an online self-help group focusing on issues of disability. Health and Social Work. 24:220–231, 1999.PubMedCrossRefGoogle Scholar
  58. 57.
    White MH, Dorman SM. Online support for caregivers; analysis of an internet Alzheimer mailgroup. Computer in Nursing 18:4:168–176, 2000.Google Scholar
  59. 58.
    Alemi F, Mosavel M, Stephens RC, Ghadiri A, Krishnaswamy J, Thakkar H. Electronic self-help and support groups. Medical Care 10(suppl):OS32–OS44, 1996.Google Scholar
  60. 59.
    Gustafson DH, Bosworth K, Hawkins RP, Boberg EW, Bricker E. CHESS: a computer-based system for providing information, referrals, decision support and social support to people facing medical and other health-related crises. Proceedings of Annual Symposium on Computer Applications in Medical Care. 1992:161–165.Google Scholar
  61. 60.
    Weinberg N, Schmale JD, Uken J, Wessel K. Computer-medicated support groups. Social Work with Groups. 17:43–54, 1995.CrossRefGoogle Scholar
  62. 61.
    Feenberg AL, Licht JM, Kane KP, Moran K, Smith RA. The online patient meeting. Journal of Neurological Science 139(suppl):129–131, 1996.CrossRefGoogle Scholar
  63. 62.
    Culver JD, Gerr F, Frumkin H. Medical information on the Internet: a study of an electronic bulletin board. Journal of General Internal Medicine. 12:466–470, 1997.PubMedCrossRefGoogle Scholar
  64. 62.
    McClung HJ, Murray RD, Heitlinger LA. The internet as a source for current patient information. Pediatrics 101:E2, 1998.PubMedCrossRefGoogle Scholar
  65. 63.
    Impicciatore P, Pandolfini C, Casella N, Bonati M. Reliability of health information for the public on the world wide web; systematic survey of advice on managing fever in children at home. British Medical Journal. 314:1875–1879, 1997.PubMedCrossRefGoogle Scholar
  66. 64.
    Eysenbach G, Diepgen, TL. Towards quality management of medical information on the internet: evaluation, labelling, and filtering of information. BMJ. 1998 Nov 28;317(7171):1496–1500.PubMedCrossRefGoogle Scholar
  67. 65.
    Coiera E. Information epidemics, economics and immunity on the internet. British Medical Journal 317:1469–1470, 1998.PubMedCrossRefGoogle Scholar
  68. 66.
    Greenfield S, Kaplan S, Ware J. Expanding patient involvement in care: effects on patient outcomes. Annuals of Internal Medicine 102:520–528, 1985.CrossRefGoogle Scholar
  69. 67.
    Brody DS, Miller SM, Lerman CE, Smith DG, Caputo GC. Patient perception of involvement in medical care: relationship to illness attitudes and outcomes. Journal of General Internal Medicine 4:506–511, 1989.PubMedCrossRefGoogle Scholar
  70. 68.
    Ambre J, Guard R, Perveiler FM, Renner J, Ripen H. White paper: criteria for assessing the quality of health information on the internet., accessed June 2000, 1999.Google Scholar
  71. 69.
    Kim P, Eng TR, Deering MJ, Maxfield A. Published criteria for evaluating health related web sites: review. BMJ. 1999 Mar 6;318(7184):647–649.PubMedCrossRefGoogle Scholar
  72. 70.
    McNab A, Anagnostelis B, Cooke A. Never mind the quality, check the badge-width! Ariadne 9:, 1997.Google Scholar
  73. 71.
    Jadad AR, Gagliardi A. Rating health information on the internet. JAMA 279: 611–614, 1998.PubMedCrossRefGoogle Scholar
  74. 72.
    Consumer Reports, Finding medical help online. 27–31, 1997.Google Scholar
  75. 73.
    Kaplan SH, Greenfield S, Ware JE. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Medical Care 27:3:110–127, 1989.CrossRefGoogle Scholar
  76. 75.
    Juge CF, Assal JR Designing computer-assisted instruction programs for diabetic patients; how can we make them really useful? Proceedings of Annual Symposium on Computer Applications in Medical Care; 215–219, 1992.Google Scholar
  77. 76.
    Marrero DG, Kronz KK, Golden MP, Wright JC, Orr DP, Fineberg NS. Clinical evaluation of computer assisted self monitoring of blood glucose system. Diabetes Care 12: 345–350, 1989.PubMedCrossRefGoogle Scholar
  78. 77.
    Nishimoto M, Kobayashi Y, Kuribayashi S, Takabayashi K, Yoshida S, Satomoro, Y. Computer-assisted instruction for diabetic patients using multimedia environment on a Macintosh computer. In: Grobe SJ, Pluyter-Wenting ESP (eds). Nursing Informatics: An international overview in a technological era. Amsterdam, The Netherlands: Elsevier 423, 1994.Google Scholar
  79. 78.
    Keoun B. At last, doctors begin to jump online. Journal of National Cancer Institute. 88:1610–1612,1996a.CrossRefGoogle Scholar
  80. 79.
    Bero L, Jadad AR. How consumers and policy makers can use systematic reviews for decisionmaking. Annals of Internal Medicine. 127:37–42, 1997.PubMedCrossRefGoogle Scholar
  81. 80.
    Borowitz SM, Wyatt JC. The origin, content and workloads of e-mail consultations. JAMA 280:1321–1324, 1998.PubMedCrossRefGoogle Scholar
  82. 81.
    Hebert H. The impact of computer-based information systems on quality patient care. Clinical Performance and Quality Health Care, 3:3:169–173,1995.PubMedGoogle Scholar
  83. 82.
    Drazen EL. Methods of evaluating costs of automated hospital information systems. In: Blum BI ed., Information systems for patient care. New York: Springer-Verlag 1019, 1984.Google Scholar
  84. 83.
    Wang CC. The future of health promotion: talkin’ technology blues. Health Promotion Practice. 1:1:77–88, 2000.CrossRefGoogle Scholar
  85. 84.
    Eng TR, Maxfield A, Patrick K, Deering MJ, Ratzan SC and Gustafson DH. Access to health information and support: a public highway or a private road? JAMA, 280:15:1371–1375, 1998.PubMedCrossRefGoogle Scholar
  86. 85.
    NHF (National Health Foundation). Consumer health information preference survey of California Internet users. Los Angeles, CA: National Health Foundation; 1998. Available at: Accessed July 2000.Google Scholar
  87. 86.
    Brownson, K. Patient handouts? We’re wasting our time. RN 56:7:88 1993.PubMedGoogle Scholar
  88. 87.
    US Department of Education. Adult Literacy in America: National Adult Literacy Survey, document #065-000-00588-3, 1993.Google Scholar
  89. 88.
    Jastak Associates Inc., Wide Range Achievement Test (WRAT3),, 1993.Google Scholar
  90. 89.
    Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB, Bairnsfather LE. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Family Medicine 25(6):391–395, 1993.PubMedGoogle Scholar
  91. 90.
    Buhle EI, Goldwein JW, Benjamin I. Oncolink: a multimedia oncology information resource on the internet. Proceeds of Annual Symposium on Computers in Applied Medical Care. 103–107, 1994.Google Scholar
  92. 91.
    Wingerson L, Simon K, Northrup L, Restino A, eds. Patient Resources on the Internet: 1997 Guide for Health Care Professionals. New York, NY: Faulkner & Gray, Inc.; 1997.Google Scholar
  93. 92.
    OTA (Office of Technology Assessment). Bringing health care online: the role of information technologies. Washington, DC: US Government Printing Office; Report OTA-ITC-624, 1995.Google Scholar
  94. 93.
    Barry MJ, Fowler FJ, Mulley AG, Henderson JV, Wennberg JE. Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Medical Care. 33:771–782, 1995.PubMedCrossRefGoogle Scholar
  95. 94.
    Firshein J. US Physicians’ malpractice data goes on Internet. Lancet 349:1155, 1997.CrossRefGoogle Scholar
  96. 95.
    Gustafson DH, Hawkins R, Boberg E, Pingree S, Serlin RE, Graziano F, Chan CL. Impact of a patient-centered, computer-based health information/support system. American Journal of Preventive Medicine. 1999 Jan: 16(1):1–9.PubMedCrossRefGoogle Scholar
  97. 96.
    Meyer H. Information systems: surfing the net for a health plan. Hospital Health Network 70:37–38, 1996.Google Scholar
  98. 97.
    Wennberg J. Shared decision making and multimedia. In: Harris LM, ed. Health and the new media: technologies transforming personal and public health. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers, 109–126,1995.Google Scholar
  99. 98.
    Campbell MK, DeVellis BM, Strecher VJ, Ammerman AS, DeVellis RF, Sandler RS. Improving dietary behavior; the effectiveness of tailored messages in primary care settings. American Journal of Public Health. 84:783–787, 1994.PubMedCrossRefGoogle Scholar
  100. 99.
    Krishna S, Balas EA, Spencer DC, Griffin JZ, Boren SA. Clinical trials of interactive computerized patient education; implications for family practice. Journal of Family Practice. 45:23–33, 1997.Google Scholar
  101. 100.
    Robinson TN. Community health behavior change through computer network health promotion; preliminary findings from Stanford Health-Net. Comput Methods Programs Biomed. 30:137–144, 1989.PubMedCrossRefGoogle Scholar
  102. 101.
    Skinner CS, Siegfried JC, Kegler MC, Strecher VJ. The potential of computers in patient education. Patient Education Counseling. 22:27–34,1993.CrossRefGoogle Scholar
  103. 102.
    Strecher VJ, Kreuter M, Den Boer DJ, Kobrin S, Hospers HJ, Skinner CS. The effects of computer-tailored smoking cessation messages in family practice settings. The Journal of Family Practice 1994 Sep: 39(3) 290–291.Google Scholar
  104. 103.
    Bluming A, Mittelman PS. Los Angeles free-net: an experiment in interactive telecommunication between lay members of the Los Angeles community and health care experts. Bulletin of Medical Library Association. 84: 217–222, 1996.Google Scholar
  105. 104.
    Gleason NA. A new approach to disordered eating-using an electronic bulletin board to confront social pressure on body image. Journal of American College Health 44:78–80, 1995.PubMedCrossRefGoogle Scholar
  106. 105.
    Weinberg N, Schmale J, Uken J, Wessel K. Online help: cancer patients participate in a computer-medicated support group. Health and Social Work. 21:24–29, 1996.PubMedGoogle Scholar
  107. 106.
    Peters R, Sikoski R. Digital dialogue. Sharing information and interest on the internet. JAMA 277:1258–1260, 1997.PubMedCrossRefGoogle Scholar
  108. 107.
    Scolamiero SJ. Support groups in cyberspace. MD Computing 14:12–17, 1997.PubMedGoogle Scholar
  109. 108.
    White BJ, and Madara EJ, eds. The self-help sourcebook: your guide to community and online support groups. 6th edition. Denville, NJ: American Self-Help Clearinghouse; 1998.Google Scholar
  110. 109.
    Ferguson T. Health care in cyberspace: patients lead a revolution. The Futurist. 31:29–33, 1997.Google Scholar
  111. 110.
    Shah NB, Der E, Ruggerio C, Heidenreich PA, Massie BM. Prevention of hospitalizations for heart failure with an interactive home monitoring program. American Heart Journal 135:373–378,1998.PubMedCrossRefGoogle Scholar
  112. 111.
    Balas EA, Austin SM, Mitchell JA, Ewigman BG, Bopp KD, Brown GD. The clinical value of computerized information services. A review of 98 randomized clinical trials. Archives of Family Medicine. 5:271–278, 1996.PubMedCrossRefGoogle Scholar
  113. 112.
    Fries JF, Koop CE, Sokolov J, Beadle CE, Wright D. Beyond health promotion: Reducing need and demand for medical care. Health Affairs 17:70–84, 1998.PubMedCrossRefGoogle Scholar
  114. 113.
    Kane B, Zands DZ. Guidelines for the clinical use of electronic mail with patients. Journal of the American Medical Informatics Association. 5:104–111, 1998.PubMedCrossRefGoogle Scholar
  115. 114.
    Mullich J. Patient heal thyself. Healthcare Informatics 27–32, 1997.Google Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Cezanne Garcia
    • 1
  1. 1.University of Washington Medical Center Patient & Family Education ServicesUniversity of WashingtonSeattleUSA

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