BackgroundPatient portals have shown promise in engaging individuals in self-management of chronic conditions by allowing patients to input and track health information and exchange secure electronic messages with their providers. Past studies have identified patient barriers to portal use including usability issues, low health literacy, and concerns about loss of personal contact as well as provider concerns such as increased time spent responding to messages. However, to date, studies of both patient and provider perspectives on portal use have focused on the pre-implementation or initial implementation phases and do not consider how these issues may change as patients and providers gain greater experience with portals.ObjectiveOur study examined the following research question: Within primary care offices with high rates of patient-portal use, what do experienced physician and patient users of the ambulatory portal perceive as the benefits and challenges of portal use in general and secure messaging in particular?MethodsThis qualitative study involved 42 interviews with experienced physician and patient users of an ambulatory patient portal, Epic’s MyChart. Participants were recruited from the Department of Family Medicine at a large Academic Medical Center (AMC) and included providers and their patients, who had been diagnosed with at least one chronic condition. A total of 29 patients and 13 primary care physicians participated in the interviews. All interviews were conducted by telephone and followed a semistructured interview guide. Interviews were transcribed verbatim to permit rigorous qualitative analysis. Both inductive and deductive methods were used to code and analyze the data iteratively, paying particular attention to themes involving secure messaging.ResultsExperienced portal users discussed several emergent themes related to a need for greater clarity on when and how to use the secure messaging feature. Patient concerns included worry about imposing on their physician’s time, the lack of provider compensation for responding to secure messages, and uncertainty about when to use secure messaging to communicate with their providers. Similarly, providers articulated a lack of clarity as to the appropriate way to communicate via MyChart and suggested that additional training for both patients and providers might be important. Patient training could include orienting patients to the “rules of engagement” at portal sign-up, either in the office or through an online tutorial.ConclusionsAs secure messaging through patient portals is increasingly being used as a method of physician-patient communication, both patients and providers are looking for guidance on how to appropriately engage with each other using this tool. Patients worry about whether their use is appropriate, and providers are concerned about the content of messages, which allow them to effectively manage patient questions. Our findings suggest that additional training may help address the concerns of both patients and providers, by providin...
BackgroundFor patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge. While this inpatient technology is in active use at only one other hospital in the United States, health care facilities are currently investing in infrastructure necessary to support large-scale deployment. Times of acute crisis such as hospitalization may increase a patient’s focus on his/her health. During this time, patients may be more engaged with their care and especially interested in using tools to manage their health after discharge. Evidence shows that enhanced patient self-management can lead to better control of chronic illness. Patient portals may serve as a mechanism to facilitate increased engagement.ObjectiveThe specific aims of our study are (1) to investigate the independent effects of providing both High Tech and High Touch interventions on patient-reported outcomes at discharge, including patients’ self-efficacy for managing chronic conditions and satisfaction with care; and (2) to conduct a mixed-methods analysis to determine how providing patients with access to MyChart Bedside (MCB, High Tech) and training/education on patient portals, and MyChart Ambulatory (MCA, High Touch) will influence engagement with the patient portal and relate to longer-term outcomes.MethodsOur proposed 4-year study uses a mixed-methods research (MMR) approach to evaluate a randomized controlled trial studying the effectiveness of a High Tech intervention (MCB, the inpatient portal), and an accompanying High Touch intervention (training patients to use the portal to manage their care and conditions) in a sample of hospitalized patients with two or more chronic conditions. This study measures how access to a patient portal tailored to the inpatient stay can improve patient experience and increase patient engagement by (1) improving patients’ perceptions of the process of care while in the hospital; (2) increasing patients’ self-efficacy for managing chronic conditions; and (3) facilitating continued use of a patient portal for care management after discharge. In addition, we aim to enhance patients’ use of the portal available to outpatients (MCA) once they are discharged.ResultsThis study has been funded by the Agency for Healthcare Research and Quality (AHRQ). Research is ongoing and expected to conclude in August 2019.ConclusionsProviding patients real-time access to health information can be a positive f...
Background Patient portals are a promising instrument to improve patient-centered care, as they provide patients information and tools that can help them better manage their health. The implementation of portals in both the inpatient and outpatient setting gives health care providers an opportunity to support patients both during hospitalization and after discharge. Thus, there is a need to better understand how inpatient and outpatient portals are used across care contexts. Objective This study aimed to examine patients’ perceptions of using inpatient and outpatient portals across the care settings, including how they used the portals and the benefits and concerns associated with portal use. Methods This study was conducted in a large Midwestern academic medical center consisting of seven hospitals. We interviewed 120 patients who had used an inpatient portal during their hospitalization, at 15 days and 6 months postdischarge, to determine their perspectives of portal use in both hospital and outpatient settings. Interview transcripts were analyzed inductively and deductively by using team coding processes consistent with a grounded theory approach. Results Interviews focused on three main areas of portal use: experience with the portal features, perceived benefits, and concerns. Responses at 15 days (n=60) and 6 months (n=60) postdischarge were consistent with respect to perceptions about portal use. Patients identified viewing their health information, managing their schedule, and communicating with providers as notable activities. Convenience, access to information, and better engagement in care were indicated as benefits. Concerns were related to technology issues and privacy/security risks. Conclusions Implementation of inpatient portals as a complement to outpatient portals is increasing and can enable patients to better manage aspects of their care. Although care processes vary substantively across settings, the benefits of convenience, improved access to information, and better engagement in care provide opportunities for portal use across care settings to support patient-centered care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.