Research Article| Volume 51, ISSUE 1, P71-77, July 2016

The Online Personal Action Plan

A Tool to Transform Patient-Enabled Preventive and Chronic Care
Published:January 26, 2016DOI:


      Patient-facing online tools for managing preventive and chronic care can be a resource-effective way to increase patient agency in health promotion. Recently, Kaiser Permanente Southern California added the Online Personal Action Plan (oPAP) to the member web portal to better enable members to access information about prevention, health promotion, and care gaps. This study described Kaiser Permanente Southern California members who use oPAP, as well as how members use oPAP to close five different care gaps: hemoglobin A1c testing, pneumonia vaccination, and three cancer screenings.


      Care gap closure rates between oPAP users and members not registered on the online patient portal between December 2014 and March 2015 were compared. Data were analyzed in 2015. A total of 838,638 cases (48.9% women; mean age, 49.5 years; 40.4% oPAP users) were examined.


      Adjusting for demographics, BMI, smoking status, health and insurance status, and number of open care gaps, oPAP access was associated with a somewhat greater likelihood of care gap closure within 90 days for select care gap types, particularly hemoglobin A1c testing and breast, cervical, and colorectal cancer screening among eligible members. The effect of oPAP access on care gap closure differed by certain ethnic minority groups.


      Although healthcare organizations have developed approaches to managing and closing preventive care gaps, these efforts are resource intensive. Users of oPAP are more likely than non-registered members to close gaps, especially cancer screening tests. The oPAP appears to be an effective tool at improving patient engagement in preventive health care.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kanter M.H.
        • Lindsay G.
        • Bellows J.
        • Chase A.
        Complete care at Kaiser Permanente: transforming chronic and preventive care.
        Jt Comm J Qual Patient Saf. 2013; 39: 484-494
        • Health Resources and Services Administration
        Clinical Quality Measures: Diabetes HbA1c {Poor Control}.
        USDHHS, Washington, DC2012
        • Beaton S.J.
        • Nag S.S.
        • Gunter M.J.
        • Gleeson J.M.
        • Sajjan S.S.
        • Alexander C.M.
        Adequacy of glycemic, lipid, and blood pressure management for patients with diabetes in a managed care setting.
        Diabetes Care. 2004; 27: 694-698
        • CDC
        Adult Vaccination Coverage—United States, 2010.
        CDC, Atlanta, GA2012
        • CDC
        Cholesterol Facts.
        CDC, Atlanta, GA2012
        • CDC
        Prevalence of cholesterol screening and high blood cholesterol among adults—United States, 2005, 2007, and 2009.
        MMWR Morb Mortal Wkly Rep. 2012; 61: 697-702
        • CDC
        Cancer screening—United States, 2010.
        MMWR Morb Mortal Wkly Rep. 2012; 61: 41-45
        • Santibanez T.A.
        • Zhai Y.
        • O’Halloran A.
        • et al.
        Flu Vaccination Coverage, United States, 2012-13 Influenza Season. CDC, Atlanta, GA2013
        • American Cancer Society
        Colorectal Cancer Facts & Figures 2011-2013.
        American Cancer Society, Atlanta, GA2011
        • Antoline C.
        • Kramer A.
        • Roth M.
        Implementation and methodology of a multidisciplinary disease-state-management program for comprehensive diabetes care.
        Perm J. 2011; 15: 43-48
        • Dell R.
        Fracture prevention in Kaiser Permanente Southern California.
        Osteoporos Int. 2011; 22: 457-460
        • Ladden M.D.
        • Bodenheimer T.
        • Fishman N.W.
        • et al.
        The emerging primary care workforce: preliminary observations from the primary care team: learning from effective ambulatory practices project.
        Acad Med. 2013; 88: 1830-1834
        • Nazi K.M.
        • Hogan T.P.
        • McInnes D.K.
        • Woods S.S.
        • Graham G.
        Evaluating patient access to Electronic Health Records: results from a survey of veterans.
        Med Care. 2013; 51(3): S52-S56
        • Matthews M.B.
        • Hodach R.
        Automation is key to managing a populationʼs health.
        Healthc Financ Manage. 2012; 66 (80): 74-78
        • Zhou Y.Y.
        • Kanter M.H.
        • Wang J.J.
        • Garrido T.
        Improved quality at Kaiser Permanente through e-mail between physicians and patients.
        Health Aff. 2010; 29: 1370-1375