scholarly journals The Promise of Patient Portals for Individuals Living With Chronic Illness: Qualitative Study Identifying Pathways of Patient Engagement (Preprint)

2020 ◽  
Author(s):  
Maureen T Stewart ◽  
Timothy P Hogan ◽  
Jeff Nicklas ◽  
Stephanie A Robinson ◽  
Carolyn M Purington ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Patient Engagement ◽  
Critical Role ◽  
Patient Portal ◽  
Patient Portals ◽  
Secure Messaging ◽  
Telephone Interviews ◽  
Wide Range ◽  
Negative Impacts

BACKGROUND Patients play a critical role in managing their health, especially in the context of chronic conditions like diabetes. Electronic patient portals have been identified as a potential means to improve patient engagement; that is, patients’ involvement in their care. However, little is known about the pathways through which portals may help patients engage in their care. OBJECTIVE Our objective is to understand how an electronic patient portal facilitates patient engagement among individuals with diabetes. METHODS This qualitative study employed semistructured telephone interviews of 40 patients living with diabetes since at least 2011, who had experienced uncontrolled diabetes, and had used secure messaging through a portal at least 4 times over 18 months. The interviews were recorded, transcribed, coded, and analyzed using primarily an inductive approach to identify how patients living with diabetes use an online health portal to support diabetes self-management. RESULTS Overall, patients who used the portal reported feeling engaged in their health care. We identified four pathways by which the portal facilitates patient engagement and some challenges. The portal provides a platform that patients use to (1) better understand their health by asking questions about new symptoms, notes, or labs, (2) prepare for medical appointments by reviewing labs and notes, (3) coordinate care between VA (Veterans Affairs) and non-VA health care teams, and (4) reach out to providers to request help between visits. Several patients reported that the portal helped improve the patient-provider relationship; however, aspects of the portal design may hinder engagement for others. Patients reported challenges with both secure messaging and access to medical records that had negative impacts on their engagement. Benefits for patient engagement were described by many types of portal users with varying degrees of diabetes control. CONCLUSIONS Patient portals support engagement by facilitating patient access to their health information and by facilitating patient-provider communication. Portals can help a wide range of users engage with their care. CLINICALTRIAL

scholarly journals The Promise of Patient Portals for Individuals Living With Chronic Illness: Qualitative Study Identifying Pathways of Patient Engagement

10.2196/17744 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17744
Author(s):  
Maureen T Stewart ◽  
Timothy P Hogan ◽  
Jeff Nicklas ◽  
Stephanie A Robinson ◽  
Carolyn M Purington ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Patient Engagement ◽  
Critical Role ◽  
Patient Portal ◽  
Patient Portals ◽  
Secure Messaging ◽  
Telephone Interviews ◽  
Wide Range ◽  
Negative Impacts

Background Patients play a critical role in managing their health, especially in the context of chronic conditions like diabetes. Electronic patient portals have been identified as a potential means to improve patient engagement; that is, patients’ involvement in their care. However, little is known about the pathways through which portals may help patients engage in their care. Objective Our objective is to understand how an electronic patient portal facilitates patient engagement among individuals with diabetes. Methods This qualitative study employed semistructured telephone interviews of 40 patients living with diabetes since at least 2011, who had experienced uncontrolled diabetes, and had used secure messaging through a portal at least 4 times over 18 months. The interviews were recorded, transcribed, coded, and analyzed using primarily an inductive approach to identify how patients living with diabetes use an online health portal to support diabetes self-management. Results Overall, patients who used the portal reported feeling engaged in their health care. We identified four pathways by which the portal facilitates patient engagement and some challenges. The portal provides a platform that patients use to (1) better understand their health by asking questions about new symptoms, notes, or labs, (2) prepare for medical appointments by reviewing labs and notes, (3) coordinate care between VA (Veterans Affairs) and non-VA health care teams, and (4) reach out to providers to request help between visits. Several patients reported that the portal helped improve the patient-provider relationship; however, aspects of the portal design may hinder engagement for others. Patients reported challenges with both secure messaging and access to medical records that had negative impacts on their engagement. Benefits for patient engagement were described by many types of portal users with varying degrees of diabetes control. Conclusions Patient portals support engagement by facilitating patient access to their health information and by facilitating patient-provider communication. Portals can help a wide range of users engage with their care.

scholarly journals Converging perspectives of providers and student users on extending a patient portal into a university-based mental health service: A qualitative study

2020 ◽  
Author(s):  
N Gasteiger ◽  
Theresa Fleming ◽  
K Day
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Qualitative Study ◽  
Health Services ◽  
Mental Health Care ◽  
Patient Portal ◽  
Patient Portals

© 2020 The Authors Background: Patient portals have the potential to increase access to mental health services. However, a lack of research is available to guide practices on extending patient portals into mental health services. This study explored stakeholder (student service users' and health providers') expectations and perceptions of extending patient portals into a New Zealand university-based mental health service. Materials and methods: This qualitative study explored the perspectives of 17 students and staff members at a university-based health and counselling service on an Internet-based patient portal through a software demonstration, two focus groups and 13 interviews. Data were analyzed thematically. Results: Staff and students perceived the patient portal as useful, easy to use and expected it to help make mental health care more accessible. Staff were most concerned with the portal's ability to support their triage processes and that it might enable students to ‘counselor hop’ (see multiple counselors). Staff recommended extension into services that do not require triage. Most students expected the portal to enhance patient-counselor contact and rapport, through continuity of care. Students were concerned with appointment waiting times, the stigmatization of poor mental health and their capacity to seek help. They considered the portal might assist with this. Students recommended extension into all services, including urgent appointments. After viewing findings from initial student and staff groups, staff concluded that extending a patient portal into their counseling services should be prioritized. Conclusion: This research suggests that there is value in extending patient portals into mental health care, especially into low-risk services. Future research should explore opportunities to support triage and appointment-making processes for mental health services, via patient portals.

Behavioral Health Patient Engagement in Video-based Visits through a Patient Portal at an Urban Safety-Net Hospital During COVID-19: Direct Patient Outreach and Case-Control Study (Preprint)

2021 ◽  
Author(s):  
Han Yue ◽  
Victoria Mail ◽  
Maura DiSalvo ◽  
Christina Borba ◽  
Joanna Piechniczek-Buczek ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Behavioral Health ◽  
Patient Engagement ◽  
Safety Net ◽  
Patient Portal ◽  
Patient Portals ◽  
Safety Net Hospital ◽  
Urban Safety

BACKGROUND Patient portals are a safe and secure way for patients to connect with providers for video-based telepsychiatry and help to overcome the financial and logistical barriers associated with face-to-face mental health care. Due to the coronavirus disease 2019 (COVID-19) pandemic, telepsychiatry has become increasingly important to obtaining mental health care. However, financial, and technological barriers, termed the “digital divide,” prevent some patients from accessing the technology needed to utilize telepsychiatry services. OBJECTIVE As part of an outreach project during COVID-19 to improve patient engagement with video-based visits through the hospital’s patient portal among adult behavioral health patients at an urban safety net hospital, we aimed to assess patient preference for patient portal-based video visits or telephone-only visits, and to identify the demographic variables associated with their preference. METHODS Patients in an outpatient psychiatry clinic were contacted by phone and preference for telepsychiatry by phone or video through a patient portal, as well as device preference for video-based visits, were documented. Patient demographic characteristics were collected from the electronic medical record. RESULTS One hundred and twenty-eight patients were reached by phone. Seventy-nine patients (61.7%) chose video-based visits and 69.6% of these patients preferred to access the patient portal through a smartphone. Older patients were significantly less likely to agree to video-based visits. CONCLUSIONS Among behavioral health patients at a safety-net hospital, there was a relatively low engagement with video-based visits through the hospital’s patient portal, particularly among older adults.

scholarly journals Mental health care professionals’ appraisal of patients’ use of online access to their electronic health record: a qualitative study. (Preprint)

2021 ◽  
Author(s):  
Antonius Mattheus van Rijt ◽  
Pauline Hulter ◽  
Anne Marie Weggelaar-Jansen ◽  
Kees Ahaus ◽  
Bettine Pluut
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Health Record ◽  
Patient Portal ◽  
Patient Access ◽  
Patient Portals ◽  
Electronic Health

BACKGROUND Patients, in a range of health care sectors, can access their medical health record using a patient portal. In mental health care, the use of patient portals among mental health care professionals (MHCPs) remains low. MHCPs worry that patient access to electronic health records will negatively affect the patient’s wellbeing and their own workload. This study explores the appraisal work carried out by MHCPs shortly after the introduction of online patient access and sheds light on the challenges MHCPs face when trying to make a patient portal work for them, the patient, and their relationship. OBJECTIVE This study aims to provide insights into the appraisal work of MHCPs to assess and understand patient access to their electronic health record (EHR) through a patient portal. METHODS We conducted a qualitative study including ten semi-structured interviews (N=11) and a focus group (N=10). Participants were MHCPs from different professional backgrounds and staff employees (e.g., team leaders, communication advisor). We collected data on their opinions and experiences with the recently implemented patient portal and their attempts to modify work practices. RESULTS Our study provides insights into MHCPs’ appraisal work to assess and understand patient access to the EHR through a patient portal. Four topics emerge from our data analysis: 1) appraising the effect on the patient-professional relationship, 2) appraising the challenge of sharing and registering delicate information, 3) appraising patient vulnerability, and 4) redefining consultation routines and registration practices. CONCLUSIONS MHCPs struggle with the effects of online patient access and are searching for the best ways to modify their registration and consultation practices. Our study suggests various solutions to the challenges faced by MHCPs. To optimize the effects of online patient access to EHRs, MHCPs need to be involved in the process of developing, implementing, and embedding patient portals.

scholarly journals Converging perspectives of providers and student users on extending a patient portal into a university-based mental health service: A qualitative study

2020 ◽  
Author(s):  
N Gasteiger ◽  
Theresa Fleming ◽  
K Day
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Qualitative Study ◽  
Health Services ◽  
Mental Health Care ◽  
Patient Portal ◽  
Patient Portals

© 2020 The Authors Background: Patient portals have the potential to increase access to mental health services. However, a lack of research is available to guide practices on extending patient portals into mental health services. This study explored stakeholder (student service users' and health providers') expectations and perceptions of extending patient portals into a New Zealand university-based mental health service. Materials and methods: This qualitative study explored the perspectives of 17 students and staff members at a university-based health and counselling service on an Internet-based patient portal through a software demonstration, two focus groups and 13 interviews. Data were analyzed thematically. Results: Staff and students perceived the patient portal as useful, easy to use and expected it to help make mental health care more accessible. Staff were most concerned with the portal's ability to support their triage processes and that it might enable students to ‘counselor hop’ (see multiple counselors). Staff recommended extension into services that do not require triage. Most students expected the portal to enhance patient-counselor contact and rapport, through continuity of care. Students were concerned with appointment waiting times, the stigmatization of poor mental health and their capacity to seek help. They considered the portal might assist with this. Students recommended extension into all services, including urgent appointments. After viewing findings from initial student and staff groups, staff concluded that extending a patient portal into their counseling services should be prioritized. Conclusion: This research suggests that there is value in extending patient portals into mental health care, especially into low-risk services. Future research should explore opportunities to support triage and appointment-making processes for mental health services, via patient portals.

scholarly journals Participants’ views and experiences from setting up a shared patient portal for primary and specialist health services- a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Torunn Hatlen Nøst ◽  
Arild Faxvaag ◽  
Aslak Steinsbekk
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Services ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Patient Involvement ◽  
Patient Portal ◽  
Care Providers ◽  
Structured Interviews ◽  
Patient Portals

Abstract Background Recently, there has been an increasing focus among healthcare organisations on implementing patient portals. Previous studies have mainly focussed on the experiences of patient portal use. Few have investigated the processes of deciding what content and features to make available, in particular for shared portals across healthcare domains. The aim of the study was to investigate views on content and experiences from the configuration process among participants involved in setting up a shared patient portal for primary and specialist health services. Methods A qualitative study including 15 semi-structured interviews with persons participating in patient portal configuration was conducted from October 2019 to June 2020. Results Whether a shared patient portal for all the health services in the region should be established was not questioned by any of the informants. It was experienced as a good thing to have numerous participants present in the discussions on configuration, but it also was said to increase the complexity of the work. The informants considered a patient portal to be of great value for patient care, among other things because it would lead to improvements in patient follow-up and increased patient empowerment. Nevertheless, some informants advocated caution as they thought the patient portal possibly could lead to an increase in healthcare providers’ workloads and to anxiety and worries, as well as to inequality in access to health care among patients. The findings were categorized into the themes ‘A tool for increased patient involvement’, ‘Which information should be available for the patient’, ‘Concerns about increased workload’, ‘Too complex to use versus not interesting enough’, ‘Involving all services’ and ‘Patient involvement’. Conclusions Establishing a shared patient portal for primary and specialist health services was considered unproblematic. There was, however, variation in opinions on which content and features to include. This variation was related to concerns about increasing the workload for health care providers, causing anxiety and inequality among patients, and ensuring that the solution would be interesting enough to adopt.

scholarly journals Using Patient Portals to Improve Patient Outcomes: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Hae-Ra Han ◽  
Kelly T Gleason ◽  
Chun-An Sun ◽  
Hailey N Miller ◽  
Soo Jin Kang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Clinical Outcomes ◽  
Patient Outcomes ◽  
Service Use ◽  
The United States ◽  
Preventive Service ◽  
Patient Portal ◽  
Patient Portals ◽  
Wide Range

BACKGROUND With the advent of electronic health record (EHR) systems, there is increasing attention on the EHR system with regard to its use in facilitating patients to play active roles in their care via secure patient portals. However, there is no systematic review to comprehensively address patient portal interventions and patient outcomes. OBJECTIVE This study aimed to synthesize evidence with regard to the characteristics and psychobehavioral and clinical outcomes of patient portal interventions. METHODS In November 2018, we conducted searches in 3 electronic databases, including PubMed, EMBASE, and Cumulative Index to Nursing and Allied Health Literature, and a total of 24 articles met the eligibility criteria. RESULTS All but 3 studies were conducted in the United States. The types of study designs varied, and samples predominantly involved non-Hispanic white and highly educated patients with sizes ranging from 50 to 22,703. Most of the portal interventions used tailored alerts or educational resources tailored to the patient’s condition. Patient portal interventions lead to improvements in a wide range of psychobehavioral outcomes, such as health knowledge, self-efficacy, decision making, medication adherence, and preventive service use. Effects of patient portal interventions on clinical outcomes including blood pressure, glucose, cholesterol, and weight loss were mixed. CONCLUSIONS Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes. Understanding the role of patient portals as an effective intervention strategy is an essential step to encourage patients to be actively engaged in their health care.

scholarly journals A Retrospective Analysis of Provider-to-Patient Secure Messages: How Much Are They Increasing, Who Is Doing the Work, and Is the Work Happening After Hours? (Preprint)

2019 ◽  
Author(s):  
Frederick North ◽  
Kristine E Luhman ◽  
Eric A Mallmann ◽  
Toby J Mallmann ◽  
Sidna M Tulledge-Scheitel ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Care Physician ◽  
Work Hours ◽  
Patient Portal ◽  
Secure Messaging ◽  
After Hours ◽  
Over Time

BACKGROUND Patient portal registration and the use of secure messaging are increasing. However, little is known about how the work of responding to and initiating patient messages is distributed among care team members and how these messages may affect work after hours. OBJECTIVE This study aimed to examine the growth of secure messages and determine how the work of provider responses to patient-initiated secure messages and provider-initiated secure messages is distributed across care teams and across work and after-work hours. METHODS We collected secure messages sent from providers from January 1, 2013, to March 15, 2018, at Mayo Clinic, Rochester, Minnesota, both in response to patient secure messages and provider-initiated secure messages. We examined counts of messages over time, how the work of responding to messages and initiating messages was distributed among health care workers, messages sent per provider, messages per unique patient, and when the work was completed (proportion of messages sent after standard work hours). RESULTS Portal registration for patients having clinic visits increased from 33% to 62%, and increasingly more patients and providers were engaged in messaging. Provider message responses to individual patients increased significantly in both primary care and specialty practices. Message responses per specialty physician provider increased from 15 responses per provider per year to 53 responses per provider per year from 2013 to 2018, resulting in a 253% increase. Primary care physician message responses increased from 153 per provider per year to 322 from 2013 to 2018, resulting in a 110% increase. Physicians, nurse practitioners, physician assistants, and registered nurses, all contributed to the substantial increases in the number of messages sent. CONCLUSIONS Provider-sent secure messages at a large health care institution have increased substantially since implementation of secure messaging between patients and providers. The effort of responding to and initiating messages to patients was distributed across multiple provider categories. The percentage of message responses occurring after hours showed little substantial change over time compared with the overall increase in message volume.

Novel use of existing technology: A preliminary study of patient portal use for telerehabilitation

2020 ◽  
pp. 1357633X2095017
Author(s):  
Susan S Conroy ◽  
Stacey Harcum ◽  
Linda Keldsen ◽  
Christopher T Bever
Keyword(s):  
Care Delivery ◽  
Health Service Delivery ◽  
Patient Portal ◽  
Significant Other ◽  
Patient Portals ◽  
Secure Messaging ◽  
Exercise Time ◽  
Stroke Population ◽  
Therapist Communication ◽  
Randomised Controlled

Patient portals (PPs) foster engagement and self-management of chronic disease and are emerging as extensions of the care continuum. Utilisation from a health service delivery perspective is growing; however, it is a relatively new model of care in the field of rehabilitation. This pilot, within a larger randomised controlled stroke rehabilitation trial, explored the feasibility and acceptance of secure messaging using an established nationwide PP system for e-visits. Fifteen participants with stroke-related arm disability were randomised to 6 weeks of home arm telerehabilitation. All were over the age of 60 and 73% lived with a spouse or significant other. Mean intervention time was 6.8 weeks, and participants sent 2.3 ± 1.4 messages per week to complete 15.1 h of reported therapy (prescribed therapy = 18 h). Portal use improved therapist efficiency and resulted in a 1:6 therapist to patient exercise time ratio compared with the conventional 1:1 ratio for in-person therapy. Low initial electronic health literacy, self-efficacy or cognitive scores did not prohibit utilisation, and satisfaction with secure messaging for patient–therapist communication was 3.5 ± 1.2 out of 5. Overall, PP-supported e-visits were a feasible and acceptable telerehabilitation care delivery method for this chronic stroke population. ClinicalTrials.gov Identifier NCT02665052. Registered 27 January 2016. https://clinicaltrials.gov/ct2/show/NCT02665052

scholarly journals A National Survey of Parent Perspectives on Use of Patient Portals for Their Children’s Health Care

2015 ◽  
Vol 06 (01) ◽  
pp. 110-119 ◽  
Author(s):  
L.E. Costello ◽  
A. Gebremariam ◽  
K.J. Dombkowski ◽  
S.J. Clark
Keyword(s):  
Health Care ◽  
National Survey ◽  
Children's Health ◽  
Children’S Health ◽  
Patient Portal ◽  
Parent Perspectives ◽  
Patient Portals ◽  
Current Utilization ◽  
Willingness To Use ◽  
Children’S Health Care

SummaryObjectives: To assess parents’ current utilization and future willingness to use patient portals to interact with their child’s health care provider.Methods: A cross-sectional survey of a nationally representative sample of US parents was conducted using an established online panel. Bivariate analyses assessed associations between current utilization and future willingness to use patient portals, parental concerns, and demographic variables.Results: Among the 1,420 parent respondents, 40% did not know whether their child’s health practice offers the option of setting up a patient portal for their child. Of the 21% of parents who reported being offered the option of setting up a patient portal for their child, 59% had done so. Among parents who had the option but chose not to set up a patient portal for their child, lack of time and low perceived need were the main reasons cited. Current use and likelihood of future use was highest for viewing lab results and immunization records. The most common concern about patient portals was the security of the child portal system.Conclusions: Current use of patient portals by parents is low. Only about half of parents currently using or likely to use a portal perceive value in using portals for certain tasks, which suggests that providers will need to continue traditional communication mechanisms to reach their entire patient population.Citation: Clark SJ, Costello LE, Gebremariam A, Dombkowski KJ. A national survey of parent perspectives on use of patient portals for children’s health care. Appl Clin Inf 2015; 6: 110–119http://dx.doi.org/10.4338/ACI-2014-10-RA-0098

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