Personal Health Records in Maternity care “a process evaluation”

Background: Personal Health Records [PHR, a private, secure, online environment for patients] have been reported to empower patients, to achieve better collaboration between health care professionals and to improve outcome. This process evaluation study explores the feasibility of the introduction of PHR in Dutch maternity care and possibilities for sustainable implementation. Methods: A process evaluation study was carried out alongside the entire period of the effect study. Quantitative and qualitative methods were used and described reach, dose delivered en dose received of the intervention. Results: 88% of the target population was reached, while 4% started a PHR [dose delivered] and 83% [out of 4%] used the PHR as intended [dose received]. It took more time for the professionals to integrate this new intervention into their care process than expected before. Pregnant women did not start a PHR when they favoured an alternative way to communicate with the health care professional or when they felt the PHR lacked additional value. Active involvement of the professional in the patients PHR is explicitly mentioned as desirable by pregnant women. Conclusions: The introduction of a PHR in maternity care is feasible, requiring the following steps: a dialogue between patients and professionals about expectations and wishes, sufficient time for the implementation, using early adopters as part of the implementation and integration of the PHR in standard care