scholarly journals Patient portal utilization: before and after stage 2 electronic health record meaningful use

2019 ◽  
Vol 26 (10) ◽  
pp. 960-967 ◽  
Author(s):  
Kea Turner ◽  
Young-Rock Hong ◽  
Sandhya Yadav ◽  
Jinhai Huo ◽  
Arch G Mainous
Keyword(s):  
Meaningful Use ◽  
Patient Portal ◽  
Patient Portals ◽  
Cross Sectional ◽  
Before And After ◽  
Health Care Policies ◽  
Race Ethnicity ◽  
Electronic Health ◽  
Independent Effects ◽  
Sectional Analysis

Abstract Objective Patient portal functionalities, such as patient–physician e-communication, can benefit patients by improving clinical outcomes. Utilization has historically been low but may have increased in recent years due to the implementation of Stage 2 Meaningful Use for electronic health records. This study has 2 objectives: 1) to compare patient portal utilization rates before Stage 2 (2011–2013) and after Stage 2 (2014–2017), and 2) to examine whether disparities in patient portal utilization attenuate after Stage 2. Materials and Methods We conducted an observational study using a pooled cross-sectional analysis of 2011–2017 National Health Interview Survey data (n = 254 183). Results The mean percent use of patient portals significantly increased from the pre-Stage 2 to the post-Stage 2 period (6.9%, 95% CI, 6.2–7.5; P < .001). Non-Hispanic Black individuals (OR 0.81, 95% CI, 0.76–0.86; P < .0001) and Hispanic individuals (OR 0.79, 95% CI, 0.74–0.84; P < .0001) have lower odds of using patient portals compared to non-Hispanic White individuals. Although we found independent effects of race/ethnicity, we did not find a statistically significant interaction between race/ethnicity and time. We found a similar level of increase in patient portal utilization from the pre- to postperiod across racial and ethnic groups. Discussion Health care policies such as Stage 2 Meaningful Use are likely contributing to increased patient portal utilization across all patients and helping to attenuate disparities in utilization between subgroups of patients. Conclusion Further research is needed to explore which patient portal functionalities are perceived as most beneficial to patients and whether patients have access to those functionalities.

scholarly journals Electronic patient portal utilization by neurology patients and association with outcomes

2020 ◽  
Vol 26 (4) ◽  
pp. 2751-2761
Author(s):  
Christa Ochoa ◽  
Jacqueline Baron-Lee ◽  
Cristina Popescu ◽  
Katharina M. Busl
Keyword(s):  
Clinical Outcomes ◽  
Outpatient Clinic ◽  
Patient Population ◽  
Patient Portal ◽  
Patient Portals ◽  
Cross Sectional ◽  
Health Events ◽  
Hispanic Patients ◽  
Demographic Patterns ◽  
Sectional Analysis

Existing literature on electronic patient portals demonstrates mixed findings for portal user demographic patterns and relationships between portal usage and clinical outcomes. This study sought to determine characteristics of portal users specific to a neurology patient population and examine whether usage predicted decreased clinic visits and risk of hospitalization. A cross-sectional analysis on 13,483 patients seen at a tertiary neurology outpatient clinic over a 1-year period found significant associations between demographics, and interactions between age, sex, and race. Black and Hispanic patients were less likely to be portal users. While females had higher odds of portal usage overall, their probability decreased with increasing age. Portal users had higher rates of clinic utilization but no difference in hospitalization risk. These results highlight demographics that may need strategic targeting to increase portal uptake and the need for other interventions for populations more likely to experience health events resulting in hospitalization.

scholarly journals Healthcare provider counselling for weight management behaviours among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011–2018

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039295
Author(s):  
Mary L. Greaney ◽  
Steven A. Cohen ◽  
Furong Xu ◽  
Christie L Ward-Ritacco ◽  
Deborah Riebe
Keyword(s):  
Older Adults ◽  
National Health ◽  
Weight Status ◽  
Calorie Intake ◽  
Nutrition Examination Survey ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Race Ethnicity ◽  
Sectional Analysis ◽  
Overweight Or Obesity

ObjectivesTo determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs’ recommendations.DesignCross-sectional analysis of 2011–2018 National Health and Nutrition Examination Survey (NHANES) data.SampleNHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158).MethodsRespondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs’ recommendations.ResultsThe sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18–39) versus middle-aged (aged 40–64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations.ConclusionMost respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.

Does uncertainty boost overconfidence? The case of financial analysts' forecasts

2014 ◽  
Vol 40 (3) ◽  
pp. 300-324 ◽  
Author(s):  
Véronique Bessière ◽  
Taoufik Elkemali
Keyword(s):  
Stock Returns ◽  
Private Information ◽  
High Tech ◽  
Cross Sectional ◽  
Forecast Dispersion ◽  
Content Type ◽  
The Public ◽  
Public Announcement ◽  
Before And After ◽  
Sectional Analysis

Purpose – This article aims to examine the link between uncertainty and analysts' reaction to earnings announcements for a sample of European firms during the period 1997-2007. In the same way as Daniel et al., the authors posit that overconfidence leads to an overreaction to private information followed by an underreaction when the information becomes public. Design/methodology/approach – In this study, the authors test analysts' overconfidence through the overreaction preceding a public announcement followed by an underreaction after the announcement. If overconfidence occurs, over- and underreactions should be, respectively, observed before and after the public announcement. If uncertainty boosts overconfidence, the authors predict that these two combined misreactions should be stronger when uncertainty is higher. Uncertainty is defined according to technology intensity, and separate two types of firms: high-tech or low-tech. The authors use a sample of European firms during the period 1997-2007. Findings – The results support the overconfidence hypothesis. The authors jointly observe the two phenomena of under- and overreaction. Overreaction occurs when the information has not yet been made public and disappears just after public release. The results also show that both effects are more important for the high-tech subsample. For robustness, the authors sort the sample using analyst forecast dispersion as a proxy for uncertainty and obtain similar results. The authors also document that the high-tech stocks crash in 2000-2001 moderated the overconfidence of analysts, which then strongly declined during the post-crash period. Originality/value – This study offers interesting insights in two ways. First, in the area of financial markets, it provides a test of a major over- and underreaction model and implements it to analysts' reactions through their revisions (versus investors' reactions through stock returns). Second, in a broader way, it deals with the link between uncertainty and biases. The results are consistent with the experimental evidence and extend it to a cross-sectional analysis that reinforces it as pointed out by Kumar.

scholarly journals Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study (Preprint)

2020 ◽  
Author(s):  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Amir Alishahi Tabriz ◽  
Christopher M Shea
Keyword(s):  
Patient Characteristics ◽  
Survey Study ◽  
Patient Portal ◽  
Older Individuals ◽  
Patient Portals ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Multiple Variable ◽  
Nationally Representative ◽  
National Trends

BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; <i>P</i>=.01). Older age (OR 1.01, 95% CI 1.00-1.02; <i>P</i>&lt;.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; <i>P</i>&lt;.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; <i>P</i>=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; <i>P</i>&lt;.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; <i>P</i>&lt;.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; <i>P</i>&lt;.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; <i>P</i>&lt;.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.

Association Between Meaningful Use and Florida Counties’ COVID-19 Case and Death Rates Among Medicaid Providers (Preprint)

2021 ◽  
Author(s):  
Katherine Freeman ◽  
Judith P. Monestime
Keyword(s):  
Electronic Health Records ◽  
Cumulative Incidence ◽  
Meaningful Use ◽  
County Level ◽  
Cross Sectional ◽  
Health Records ◽  
Death Rates ◽  
Public Health Reporting ◽  
Electronic Health ◽  
Population Demographic

BACKGROUND Although the Health Information Technology for Economic and Clinical Health (HITECH) Act has accelerated the adoption of Meaningful Use of Electronic Health Records (EHRs) among Medicaid providers, only about half achieve Meaningful Use. Furthermore, the validity of public health reporting of COVID-19 outcomes, which relies on Meaningful Use advanced functions, remains unknown. OBJECTIVE This study aims to examine the difference between Medicaid providers who did and did not achieve Meaningful Use regarding Florida county-level incidence rates of COVID-19 cases and deaths, accounting for county-level race/ethnicity, unemployment, income, prevalence of respiratory diseases, age, poverty, and healthcare environment. METHODS This cross-sectional ecologic study examined the association between Meaningful Use achievement by Medicaid providers and COVID-19 cases and death rates from 67 Florida counties as of November 19, 2020. Provider information was obtained from the publicly available database from the Florida Medicaid Promoting Interoperability Program, formerly Electronic Health Record Incentive Program. The database includes the Area Health Resources File, capturing provider characteristics and population demographic and socioeconomic characteristics at the county level. Cumulative COVID-19 cases and deaths were obtained from the Florida Department of Health Open Data (FDOH) for zip codes which were aggregated by county. Rates were obtained by dividing cumulative incidence or prevalence by the U.S. Census County population. RESULTS As of November 19, 2020, the cumulative incidence rate of COVID-19 deaths was significantly different between Medicaid providers who achieved Meaningful Use and those who did not (P=.0131), with relatively more deaths reported for those not achieving Meaningful Use. County-level characteristics associated with increased COVID-19 death rates in hierarchical models include greater concentrations of persons of African American or Black race (P<.0001), lower median household income (P<.0001), higher unemployment (P<.0001), and higher concentrations of those living in poverty (P<.0001) and without health insurance (P<.0001). CONCLUSIONS Although Federal subsidies successfully influenced the adoption of Electronic Health Records, our findings suggest an emerging further digital "advanced use" divide among patients cared for by Medicaid providers. Policy interventions need to be reevaluated to address disparities in COVID-19 clinical outcomes which appear exacerbated by the limited use of advanced Electronic Health Records functions. CLINICALTRIAL not applicable

Chinese Americans’ use of patient portal systems: a scoping review (Preprint)

2021 ◽  
Author(s):  
Katharine Lawrence ◽  
Stella Chong ◽  
Holly Krelle ◽  
Timothy Roberts ◽  
Lorna Thorpe ◽  
...  
Keyword(s):  
Scoping Review ◽  
Chinese American ◽  
Chinese Americans ◽  
Barriers And Facilitators ◽  
Future Research ◽  
Sample Population ◽  
Patient Portal ◽  
Patient Portals ◽  
Cross Sectional ◽  
Use Patterns

BACKGROUND Patient portals are increasingly deployed in healthcare systems as communication and information-sharing tools for patients and providers. While portals show promise in addressing healthcare access, quality, and outcomes, research on portal access and use patterns among diverse populations is limited, including among Chinese Americans. OBJECTIVE This study aimed to summarize existing evidence on the access and use patterns, barriers, and facilitators of patient portals among Chinese Americans, and to identify gaps and areas for future research. METHODS The authors conducted a scoping review using the PRISMA Protocol for Scoping Reviews of articles published in major databases (MEDLINE, Embase, PsycINFO) on the topic of patient portals and Chinese Americans. Authors independently reviewed the papers during initial screening and full-text review. The studies were analyzed and coded for study method type, sample population, and main outcomes of interest. RESULTS In total 17 articles were selected for inclusion in the review. The included articles varied in study aims, methodology, data collection, sample population, and geographic areas of study. The majority of studies were cross-sectional in nature. Major findings and themes identified from the articles include: variable patterns of patient portal access and use among Chinese Americans compared to other racial/ethnic groups; limited evidence on the specific barriers and facilitators of access and use for this group; a reliance on quantitative proxy measures (e.g. log-ins, click-throughs) to assess portal access and use; and a pattern of aggregating Chinese American-related data into a larger Asian or Asian American designation. CONCLUSIONS There is limited research dedicated to understanding the use patterns, experiences, and needs of Chinese Americans who access and utilize patient portal systems. Most research is cross-sectional, focusing on disparities in use and access, and have tended to aggregate the Chinese American experience into that of Asian Americans. Future research should focus specifically on Chinese Americans and prioritize more detailed evaluations of their relationship to patient portal technology to understand specific use patterns, preferences, and needs. A broader understanding of the diversity of health technology users can help ensure applicable and equitable design, development, and implementation of these tools. CLINICALTRIAL N/a

Electronic Health Record Patient Portals and the Blockchain Technology

2021 ◽  
pp. 218-227
Author(s):  
Jorge Tavares
Keyword(s):  
Medical Information ◽  
Healthcare Providers ◽  
Appointment Scheduling ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Blockchain Technology ◽  
Electronic Health ◽  
Implementation Of Ehr ◽  
E Mail

The electronic health records (EHR) patient portals are an integrated eHealth technology that combines an EHR system and a patient portal, giving patients access to their medical records, exam results, and services, such as appointment scheduling, notification systems, and e-mail access to their physician. EHR patient portals empower patients to carry out self-management activities and facilitate communication with healthcare providers, enabling the patient and healthcare provider to access the medical information quickly. Worldwide governmental initiatives have aimed to promote the use of EHR patient portals. The implementation of EHR patient portals encompasses several challenges, including security, confidentiality concerns, and interoperability between systems. New technological approaches like blockchain could address these issues and enable a successful worldwide implementation of EHR patient portals.

OP140 Adult Patient Access To Electronic Health Records

2019 ◽  
Vol 35 (S1) ◽  
pp. 32-32
Author(s):  
Petra Schnell-Inderst ◽  
Stefanie Neyer ◽  
Alexander Hörbst ◽  
Gerhard Müller ◽  
Uwe Siebert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cochrane Review ◽  
Patient Empowerment ◽  
Significant Risk ◽  
Study Groups ◽  
Composite Score ◽  
Patient Portal ◽  
Patient Portals ◽  
Health Related ◽  
Electronic Health

IntroductionIn order to facilitate patient information, patient involvement, and to support patient-centered care, healthcare organizations are increasingly offering access to patient data that are stored in the institution-specific electronic health record (EHR). Patients can access these data, read, and print them, or download and integrate them into any type of patient-held record. This EHR access is typically web-based and called “patient portal” allowing the independent access via the Internet from everywhere. A patient portal may also offer additional features such as prescription requests, appointment booking, messaging, personal health-related reminders, individual therapeutic recommendations, personal diaries, and social networking with other patients. In a Cochrane review, we assessed the effects of providing access to EHR for adult patients on patient empowerment and health-related outcomes compared to usual care.MethodsAccording to the methods of evidence-based medicine, we developed a protocol for a Cochrane review, which is published in the Cochrane database.ResultsWe identified ten randomized controlled trials (RCTs) including 6,668 randomized participants. Seven RCTs took place in the USA, two in Canada, and one in Japan. Additional functionalities of interventions and disease conditions were heterogeneous. Three studies (n = 601) reported on patient empowerment. The risk differences reported were neither statistically significant nor clinically relevant. Eight studies (n = 2,070) reported on nine different risk factors (blood pressure, blood glucose, poor asthma control, 10-year Framingham risk score, cholesterol, body mass index, composite score of eight variables, intraocular pressure, composite score of three variables). The results were heterogeneous. Mostly there were no statistically significant risk differences between study groups.ConclusionsOverall, there is no evidence for a clear positive effect of patient portals on patient empowerment and health related outcomes (mainly risk factors). However, we identified only a small number of studies. The usage of portals was often low and several studies were older.

scholarly journals Multiple Sclerosis and MyChart Messaging: A Retrospective Review Evaluating Its Use

2021 ◽  
Vol preprint (2021) ◽  
pp. 0000-0000
Author(s):  
Nadia Khalil ◽  
Angela Aungst ◽  
Lise Casady ◽  
Kevin Allison ◽  
Ryann Fiascki ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Patient Portal ◽  
Cross Sectional ◽  
Quality Improvement Research ◽  
Time Investment ◽  
Risk Patients ◽  
Utilization Patterns ◽  
Hand Disability ◽  
Sectional Analysis ◽  
Disease Specific

Abstract Background: Understanding patterns of MyChart (Epic Systems Corp) messaging has the potential to alter clinical practice. However, because most research evaluating its use has been conducted in limited contexts, utilization patterns in patients with multiple sclerosis (MS) remain unclear. We characterized factors associated with high rates of MyChart messaging in patients with MS. Methods: We performed a retrospective cross-sectional analysis of adult patients in an academic outpatient clinic’s database (N = 439). Inclusion criteria were one or more clinic visits and MS diagnosis. We extracted demographic and disease-specific characteristics and MyChart messaging information. Results: MyChart users in the database totaled 74% (n = 324). MyChart users were more often younger, had shorter duration since diagnosis, had lower Patient-Determined Disease Steps scores, and were more likely to be using high-efficacy disease-modifying therapies than nonusers. Messaging rates were positively correlated with total number of unique medications (R = 0.17, P = .003) and negatively correlated with age (R = –0.11, P = .018). Conclusions: Although research has implicated arm-hand disability and impaired vision as barriers to patient portal use, these findings suggest the relationship between MS-specific disease burden and MyChart utilization is also a function of underlying medical complexity in capacities beyond physical disability. These data may serve as groundwork for investigation into other disease-specific settings and for quality improvement research to mitigate these high rates in at-risk patients, optimizing provider time investment, clinic productivity, and patient safety and preventing health care provider burnout.

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