Health Coaching via an Internet Portal for Primary Care Patients with Chronic Conditions

A Randomized Controlled Trial

Patients suffering one of three chronic conditions reported improved communication with their primary care physician (PCP) after receiving advice and encouragement through an online intervention. A study tested digital interactive strategies for enhancing self-care.

The Beth Israel Deaconess Medical Center in Boston (BIDMC) uses a secure Internet portal, PatientSite, to communicate with over 30,000 patients. PatientSite services include electronic messaging, appointment scheduling, handling prescription and referral requests, and making available medical records, including radiology and laboratory reports.

An intervention conducted over PatientSite provided nurse e-coaches to a targeted sample of patients enduring chronic musculoskeletal pain, depression, or limited mobility. The intervention was administered prior to patient-PCP visits occurring between August 2005 and August 2006. An initial, standardized PatientSite message emphasized active participation in the patient-physician relationship. A link to the intervention Web site provided additional correspondence tools and a platform for communicating with the e-coach.

Key Findings:

  • More intervention (94%) than control (84%) group participants said that their PCP gave them specific advice.
  • The percentage of intervention group patients whose PCP referred them to a specialist was almost twice the control group rate.

Principles of behavior change based on Social Cognitive Theory informed the design of this intervention.

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