scholarly journals An Explorative Longitudinal Study on the Five-Year Patient Portal Use among an Underserved Patient Population

2019 ◽  
Vol 8 (1) ◽  
pp. 146-146
Author(s):  
Ana Ongtengco ◽  
Kevin Roy ◽  
Liang Zhang ◽  
Jessie Chin
Keyword(s):  
Health Information ◽  
Patient Population ◽  
Healthcare Providers ◽  
Patient Portal ◽  
Test Results ◽  
Patient Portals ◽  
Patient Centered ◽  
Medical Test ◽  
Centered Care ◽  
Data Points

The purpose of the study was to identify and assess multiple aspects of patient portal usage behavior in an underserved urban patient population. Given the rise of patient-centered care, patients are required to take active roles to gather health information, make informed health decisions and manage their own healthcare, which behavior were associated with health outcome (Barry & Edgman-Levitan, 2012; Oates, Weston & Jordan, 2000). Patient portals serve as a mean to coordinate patient-centered care by delivering health information to patients (e.g. medical test results), exchanging information with healthcare providers (e.g., messaging providers), and facilitating the delivery of health care services (e.g., scheduling appointments). However, studies often showed that patients in underserved communities did not take full advantages of the patient portals (e.g,. Cazaja et al., 2015, Wallace et al., 2016). These disparities in patient portal usages were associated with many factors, including the complexities of the American healthcare system, lack of internet access, lack of support to navigate through the health systems, and the lack of health literacy among an underserved adult population. To better understand the current use of patient portal of an underserved patient population, we conducted an explorative analysis of portal usage at the University of Illinois Hospitals and Health Sciences System (UIHealth). UIHealth serves throughout the city of Chicago, including areas with high racial segregation (minority population higher than 75%), where patients’ household income is lower than the median of Chicago residents. The majority of patient populations in UIHealth are African Americans (61%) followed by Hispanic/Latino (17%) and White (17%). The study was conducted using a retrospective analysis of Google Analytics portal data from March 2015 to March 2019. User behavior data were extracted to show aspects of usage, including most popular portal functions, language used, time spent on each page, and returning user visits, etc. We used weekly summary data as individual data points (208 data points in total) in the analysis. We found that, over four years, both retuning and new users increased by more than 50%. Regarding the number of users per week, there were local drops in the overall growth which drops were associated with fewer visits to UIHealth during holidays or cold weather. Hence, portal visits were associated with clinic visits. With regards to the most popular functions, writing messages to healthcare providers and viewing medical test results were the most used functions over the years. Results suggested that patients would utilize portal to gather information about their health status (for later discussion with physicians or making informed decisions) and communicate with healthcare providers. Interestingly, we found the dominant devices used to access the portal have shifted from desktop computers (2015-2017) to mobile phones (2017-2019), suggesting the increasing need to present health information in bitable size in smaller screens; and the increasing smartphone adoptions of underserved adults as an alternative solution to get internet access. Overall, improving the accessibility of patient portals remains to be a major issue for empowering patients in contemporary value-based healthcare systems. The explorative study has shed lights on the longitudinal trends of portal usage among an underserved population, which creates practical implications on the design of a more efficient interface between patients and their healthcare providers with the ultimate goal to improve health equity.

Association between Patient Portal Usage and Perceived Patient-Centered Communication among Adults with Cancer: Cross-Sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Maryum Zaidi ◽  
Daniel J. Amante ◽  
Ekaterina Anderson ◽  
Mayuko Ito Fukunaga ◽  
Jamie Marie Faro ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Health Information ◽  
Information Seeking ◽  
Self Efficacy ◽  
Multinomial Logistic Regression ◽  
Patient Portal ◽  
Health Information Seeking ◽  
Patient Portals ◽  
Patient Centered ◽  
Cancer Management

BACKGROUND Patient-centered communication (PCC) plays a vital role in effective cancer management and care. Patient portals are increasingly available to patients and hold potential as a valuable tool to facilitate PCC. However, whether the use of patient portals may improve perceived PCC or which mechanisms might mediate this relationship has not been studied. OBJECTIVE The primary goal of this study was to investigate the association between the frequency of access to patient portals and perceived PCC in patients with cancer. A secondary goal was to explore whether this association was mediated by patients' self-efficacy in health information seeking. METHODS We used data from the Health Information National Trend Survey 5 (HINTS 5) cycle 3 (2019) and cycle 4 (2020). The present analysis includes 1,222 individuals who self-reported having a current or past diagnosis of cancer. Perceived PCC was measured with a 7-item HINTS derived scale and classified as low, medium, or high. Patient portal usage was measured by a single item assessing the frequency of use. Self-efficacy about health information seeking was assessed with a one-item measure assessing confidence in obtaining health information. We used adjusted multinomial logistic regression models to estimate relative risk ratios (RRR) of the association between patients' patient portal usage and perceived PCC. Mediation by health information self-efficacy was investigated using the Baron and Kenny and Karlson, Holm, and Breen methods. RESULTS 54.5% of the sample reported that they did not access their patient portals in the past 12 months, 12.6 % accessed it 1-2 times, 24.8% accessed it 3-9 times, and 8.2% accessed it 10 or more times. Overall, the frequency of accessing the patient portal was marginally associated (P=0.06) with perceived PCC in an adjusted multinominal logistic regression model. Patients who accessed their patient portal 10 or more times in the previous 12 months were almost 4 times more likely (RRR=3.8; 95% CI 1.6–9.0) to report high perceived PCC. In mediation analysis, the association between patient portal use and perceived PCC was attenuated adjusting for health information seeking self-efficacy, but those with the most frequent patient portal use (ten or more times in the previous 12 months) were still almost 2.5 times more likely to report high perceived PCC (RRR=2.4; 95% CI 1.1–5.6) compared to those with no portal use. CONCLUSIONS PCC is an integral part of patient-centered care. Those who reported the greatest use of patient portals were more likely to report higher perceived PCC. These findings emphasize the importance of encouraging cancer patients and providers to use patient portals to increase patient-centeredness of care and suggest that interventions to promote the adoption and use of patient portals could incorporate strategies to improve health information self-efficacy.

scholarly journals Designing a portal to patient-centered care? Let�s start with the patient. A cross-sectional survey. (Preprint)

2017 ◽  
Author(s):  
Steve Alfons Van den Bulck ◽  
Rosella Hermens ◽  
Karin Slegers ◽  
Bert Vandenberghe ◽  
Geert Goderis ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Shared Decision Making ◽  
Information Needs ◽  
Patient Portal ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

BACKGROUND In recent literature, patient portals are considered as important tools for the delivery of patient-centered care. Yet, it is not clear how patients would conceptualize a patient portal and which health information needs they have when doing so. OBJECTIVE 1) To investigate health information needs, expectations and attitudes towards a patient portal. 2) To assess if determinants such as patient characteristics, health literacy and empowerment status can predict two different variables, namely the importance people attribute to obtaining health information when using a patient portal and the expectations concerning personal healthcare when using a patient portal. METHODS A cross-sectional survey was performed in the Flemish population on what patients prefer to know about their digital health data and on their expectations and attitudes towards using a patient portal to access their Electronic Health Record. People were invited to participate in the survey through newsletters, social media and magazines. We used a questionnaire including demographics, health characteristics, health literacy, patient empowerment and patient portal characteristics. RESULTS We received 433 completed surveys. The health information needs included features such as being notified when one’s health changes (93.7%, 371/396), being notified when physical parameters rise to dangerous levels (93.7%, 370/395), to see connections between one’s symptoms/diseases/biological parameters (85.2%, 339/398), to view the evolution of one’s health in function of time (84.5%, 333/394) and to view information about the expected effect of treatment (88.4%, 349/395). Almost 90% (369/412) of respondents were interested in using a patient portal. Determinants of patients’ attachment to obtaining health information on a patient portal were 1) age between 45 and 54 years (P = .047); 2) neutral (P = .030) or interested attitude (P = .008) towards shared decision-making; 3) commitment to question the physicians’ decisions (P = .030). (R2 = .122) Determinants of patients’ expectations on improved healthcare by accessing a patient portal were 1) lower education level (P = .040); 2) neutral (P = .030) or interested attitude (P = .008) towards shared decision-making; 3) problems in understanding health information (P = .037). (R2 = .106) CONCLUSIONS The interest in using a patient portal is considerable in Flanders. People report they would like to receive alerts or some form of communication from a patient portal in case they need to take action to manage their health. Determinants such as education, attached importance to shared decision-making, difficulties in finding relevant health information and the attached importance to questioning the decisions of physicians need to be taken into account in the design of a patient portal.

scholarly journals Health Information Technology Challenges to Support Patient-Centered Care Coordination

2015 ◽  
Vol 24 (01) ◽  
pp. 8-10 ◽  
Author(s):  
B. Séroussi ◽  
M.-C. Jaulent ◽  
C. U. Lehmann
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Care Coordination ◽  
Clinical Pathways ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Holistic View ◽  
25Th Anniversary ◽  
Centered Care

Summary Objectives: To provide an editorial introduction to the 2015 IMIA Yearbook of Medical Informatics. Methods: We provide a brief overview of the 2015 special topic “Patient-Centered Care Coordination”, discuss the addition of two new sections to the Yearbook, Natural Language Processing and Public Health & Epidemiology Informatics, and present our editorial plans for the upcoming celebration of the 25th anniversary of the Yearbook. Results: Care delivery currently occurs through the processing of complex clinical pathways designed for increasingly multi-morbid patients by various practitioners in different settings. To avoid the consequences of the fragmentation of services, care should be organized to coordinate all providers, giving them the opportunity to share the same holistic view of the patient’s condition, and to be informed of the planned clinical pathway that establishes the roles and interventions of each one. The adoption and use of electronic health records (EHRs) is a solution to address health information sharing and care coordination challenges. However, while EHRs are necessary, they are not sufficient to achieve care coordination, creating information availability does not mean the information will be accessed. This edition of the Yearbook acknowledges the fact that health information technology (HIT), and EHRs in particular, are not yet fully addressing the challenges in care coordination. Emerging trends, tools, and applications of HIT to support care coordination are presented through the keynote paper, survey papers, and working group contributions. Conclusions: In 2015, the IMIA Yearbook has been extended to emphasize two fields of biomedical informatics through new sections. Next year, the 25th anniversary of the Yearbook will be celebrated in grand style! A special issue with a touch of reflection, a bit of rediscovery, and some “science-fiction” will be published in addition to the usual edition.

Healthcare Providers’ Attitudes, Knowledge, and Practice Behaviors for Educating Patients About Advance Directives: A National Survey

2018 ◽  
Vol 36 (5) ◽  
pp. 387-395 ◽  
Author(s):  
Frances R. Nedjat-Haiem ◽  
Tamara J. Cadet ◽  
Anup Amatya ◽  
Shiraz I. Mishra
Keyword(s):  
Online Survey ◽  
Survey Design ◽  
Healthcare Providers ◽  
Medical Decision ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Practice Behaviors ◽  
Centered Care ◽  
Seriously Ill Patients

Background: Advance care planning for end-of-life care emerged in the mid-1970’s to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers. Objective: Study aims examine providers’ perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation. Design: To examine providers’ views, we conducted a cross-sectional, online survey questionnaire of healthcare providers using social media outreach methods for recruitment. Methods: This study used a cross-sectional survey design to examine the proposed aims. Healthcare providers, recruited through a broad approach using snowball methods, were invited to participate in an online survey. Logistic regression analyses were used to examine providers’ views toward AD education. Results: Of 520 participants, findings indicate that most healthcare providers said that they were knowledgeable about AD education. They also viewed providing education as beneficial to their practice. These findings suggest that having a positive attitude toward AD education and experiencing less organizational barriers indicate a higher likelihood that providers will educate patients regarding ADs. Conclusion: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care.

Caring for Patients with Service Dogs: Information for Healthcare Providers

2016 ◽  
Vol 22 (1) ◽  
Author(s):  
Michelle Krawczyk
Keyword(s):  
Emotional Support ◽  
Healthcare Providers ◽  
Background Information ◽  
Future Research ◽  
Service Dogs ◽  
Patient Centered ◽  
Service Dog ◽  
Healthcare Settings ◽  
Centered Care

People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.

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.

Thoughts About Meanings of Compliance, Adherence, and Concordance

2020 ◽  
Vol 33 (4) ◽  
pp. 358-360
Author(s):  
Jacqueline Fawcett
Keyword(s):  
Conceptual Model ◽  
Patient Autonomy ◽  
Healthcare Providers ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Or Groups ◽  
Health Related Behaviors ◽  
Centered Care ◽  
Health Related

The purpose of this essay is to explore the meanings of the widely used terms compliance and adherence and the less widely used term concordance and to raise questions about the appropriateness of these terms when used to describe individuals’ or groups’ health-related behaviors. Discussion focuses on how recognition of how the meanings of these terms has uncovered the failure to honor nursing’s emphasis on person/patient-centered care due to power imbalances between healthcare providers and patents and the subsequent lack of patient autonomy. Consideration of these problems with existing terms could facilitate identification of a potentially more appropriate term based on the language of a nursing conceptual model and/or theory.

scholarly journals The evolution of quality improvement in healthcare: Patient-centered care and health information technology applications

2016 ◽  
Vol 5 (2) ◽  
pp. 62 ◽  
Author(s):  
John Cantiello ◽  
Panagiota Kitsantas ◽  
Shirley Moncada ◽  
Sabiheen Abdul
Keyword(s):  
Information Technology ◽  
Quality Improvement ◽  
Health Information Technology ◽  
Health Information ◽  
Patient Centered Care ◽  
Healthcare Industry ◽  
Patient Centered ◽  
Technology Applications ◽  
Centered Care

Objective: Quality improvement in the healthcare industry has evolved over the past few decades. In recent years, an increased focus on coordination of care efforts and the introduction of health information technology has been of high importance in improving the quality of patient care.Methods: In this review, we present a history of quality improvement efforts, discuss quality improvement in the healthcare industry, and examine quality improvement strategies with a focus on patient-centered care and information technology applications via patient registries.Results: Evidence shows that the key to quality improvement efforts in the healthcare industry is the coordination of patient care efforts through better data evaluation processes. By utilizing patient registries that can be linked to electronic health records (EHRs) and the Patient-Centered Medical Home (PCMH) framework, the quality of care provided to patients can be improved.Conclusions: While many healthcare organizations have quality improvement departments or teams in place that may be able to handle these types of efforts, it is important for organizations to be familiar with processes and frameworks that employees at different levels of the organization can be involved in. In order to ensure successful outcomes from quality improvement initiatives, managers and clinicians should work together in identifying problems and developing solutions.

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