The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review

Background Patient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear. Objective The aim of this systematic review was to summarize evidence on the impact of patient portals on health outcomes and health care efficiency, and to examine user characteristics, attitudes, and satisfaction. Methods We searched the PubMed and Web of Science databases for articles published from January 1, 2013, to October 31, 2019. Eligible studies were primary studies reporting on the impact of patient portal adoption in relation to health outcomes, health care efficiency, and patient attitudes and satisfaction. We excluded studies where portals were not accessible for patients and pilot studies, with the exception of articles evaluating patient attitudes. Results Overall, 3456 records were screened, and 47 articles were included. Among them, 11 studies addressed health outcomes reporting positive results, such as better monitoring of health status, improved patient-doctor interaction, and improved quality of care. Fifteen studies evaluated the impact of digital patient portals on the utilization of health services with mixed results. Patient characteristics were described in 32 studies, and it was reported that the utilization rate usually increases with age and female gender. Finally, 30 studies described attitudes and defined the main barriers (concerns about privacy and data security, and lack of time) and facilitators (access to clinical data and laboratory results) to the use of a portal. Conclusions Evidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy. It is still unclear whether the use of patient portals improves health service utilization and efficiency.

EVALUATION OF EFFICACY OF DIFFERENT METHODS FOR MICROBIAL ECZEMA TREATMENT

The aim of the study is to analyze the effectiveness of the methods of treatment (MT) of microbial eczema (ME) available in pediatric practice. Materials and methods of research: the article presents the results of the evaluation of efficacy of the methods of treatment of ME in 108 patients aged 1–13 years with ME, taking into account the study of their safety and financial feasibility. ME severity was assessed using IOSTME (Microbial Eczema Severity Evaluation Index). The efficacy of ME therapy was assessed using clinical criteria. Results: with the same safety and clinical efficacy, the use of cold atmospheric plasma (CAP) in the complex therapy of ME has an advantage over the standard treatment method (MT1) and over complex therapy using laser therapy (MT2). The health care efficiency (Km) differed in the use of analytic treatments with the highest proportion of clinical recovery results (complete skin cleansing) in patients receiving complex therapy using CAP (MT3): when using MT1 – in 1 out of 20 cases (5%), with MT2 – in 3 out of 49 patients (6%), with MT3 – in 26 out of 39 cases (67%) (p<0,001). The decrease in the cost of complex treatment methods (MT2 and MT3) was due to a significant reduction in the duration of inpatient treatment: when using MT1 – 14,5 [14,0; 15,0], MT2 – 11,0 [10,0; 12,0], MT3 – 6,0 [6,0; 6,0] bed-days, despite the more expensive medical services for MT2 (1,37 times more expensive than MT1) and MT3 (2,33 times more expensive than MT1 and 1,71 times more expensive than MT2). Conclusion: the use of CAP in the complex treatment of ME is effective, safe and cost-effective.

Maintaining fair and efficient health care during the COVID-19 pandemic: Theoretical context and practical implications

Coronavirus disease 2019 is a respiratory infection that has evolved to a pandemic with an enormous burden both on human life and health care. States throughout the world have pursued strategies to restrict the transmission of the virus in the community. Health systems have a crucial dual role as they are at the frontline of the fight against the pathogen and at the same time they must continue to offer emergency and routine health services. The provision of health care in the context of the COVID-19 pandemic finds certain barriers. The simultaneous protection of both universal health coverage and health care efficiency is a difficult task due to conflicting challenges of these two goals. Key actions need to be decided and implemented in the fields of health policy, operation of health services, and clinical interaction between health personnel and patients, so that health care continues to perform its mission in a sustainable manner. As the scientific community prepares for the widespread production and application of effective protective and therapeutic agents against COVID-19, it is vital for the general population to remain safe and for the health systems to survive. Allocation of resources and priority setting need to be applied fairly and efficiently for the achievement of the maximum benefit.

Machine Learning-Based Predictive Analytics Marketed as Improving Health Care Efficiency: What Types of Products and Who is Marketing Them? (Preprint)

BACKGROUND Considerable effort is devoted to development of artificial intelligence, including machine learning-based predictive analytics (MLPA), for use in health care settings. Growth of MLPA could be fueled by payment reforms that hold health care organizations responsible for providing high quality, cost-effective care. Policy analysts, ethicists and computer scientists have identified unique ethical and regulatory challenges from MLPA in health care. However, little is known about the types of MLPA health care products available on the market today or what their stated goals are. OBJECTIVE To better characterize available products, we identified and characterized claims about products currently in use in U.S. health care settings that are marketed as tools to improve health care efficiency by improving quality of care while reducing costs. METHODS We conducted systematic database searches of relevant business news and academic research to identify MLPA products for health care efficiency that met our inclusion and exclusion criteria. We used content analysis to generate MLPA product categories and to characterize the organizations marketing the products. RESULTS We identified 106 products and characterized them based on publicly available information in terms of the types of predictions made, and the size, type, and clinical training of the leadership of the companies marketing them. We identified five categories of predictions made by MLPA products based on the publicly available product marketing materials: disease onset and progression, treatment, cost and utilization, admissions and readmissions, and decompensation and adverse events. CONCLUSIONS Our findings provide a foundational reference to inform analysis of the specific ethical and regulatory challenges arising from the use of MLPA to improve healthcare efficiency.

The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review (Preprint)

BACKGROUND Patient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear. OBJECTIVE The aim of this systematic review was to summarize evidence on the impact of patient portals on health outcomes and health care efficiency, and to examine user characteristics, attitudes, and satisfaction. METHODS We searched the PubMed and Web of Science databases for articles published from January 1, 2013, to October 31, 2019. Eligible studies were primary studies reporting on the impact of patient portal adoption in relation to health outcomes, health care efficiency, and patient attitudes and satisfaction. We excluded studies where portals were not accessible for patients and pilot studies, with the exception of articles evaluating patient attitudes. RESULTS Overall, 3456 records were screened, and 47 articles were included. Among them, 11 studies addressed health outcomes reporting positive results, such as better monitoring of health status, improved patient-doctor interaction, and improved quality of care. Fifteen studies evaluated the impact of digital patient portals on the utilization of health services with mixed results. Patient characteristics were described in 32 studies, and it was reported that the utilization rate usually increases with age and female gender. Finally, 30 studies described attitudes and defined the main barriers (concerns about privacy and data security, and lack of time) and facilitators (access to clinical data and laboratory results) to the use of a portal. CONCLUSIONS Evidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy. It is still unclear whether the use of patient portals improves health service utilization and efficiency.

INCREASING THE EFFICIENCY OF REGULATING DEMOGRAPHIC PROCESSES IN THE REPUBLIC OF UZBEKISTAN

The article considers economic and health care efficiency of population growth in the Republic of Uzbekistan and develops scientific proposals and recommendations for improving the state regulation of demographic processes. Keywords: population, demographic processes, economic efficiency, healthcare costs.