Design and Development of a Person-Centered Patient Portal Using Participatory Stakeholder Co-Design

Kildea, J.; Battista, John A. Di; Cabral, Briana; Hendren, Laurie; Herrera, David; Hijal, Tarek; Joseph, Ackeem

doi:10.2196/11371

Cited by 77 publications

(90 citation statements)

References 38 publications

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“…There are complex individual factors that influence patient portal adoption [48]. The match between the design of the portal and patient expectations influences adoption and continued use [49], and some institutions have extensively incorporated stakeholder input into the portal design [50]. An example of incorporating user input to improve the adoption and use of MyChart is a project at the Johns Hopkins School of Medicine that trained volunteers to educate adolescent and young adult patients about the patient portal and to then facilitate enrollment and, for those interested, downloads of the MyChart mobile app [51].…”

Section: Discussionmentioning

confidence: 99%

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

Foster¹,

Krasowski²

2019

J Med Internet Res

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Background Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients. Objective The study aimed to assess patient portal utilization by ED patients at an academic medical center using account activation rates along with the rates of access of diagnostic test results (laboratory results and radiology reports), analyzing the impact of age, gender, and self-reported patient race. Methods This institutional review board–approved retrospective study was performed at a 60,000-visits-per-year university-based ED. We utilized EHR data reporting tools to examine EHR portal activation and utilization for all patients who had at least one ED encounter with one or more diagnostic tests performed between October 1, 2016, and October 1, 2017. The total dataset for laboratory testing included 208,635 laboratory tests on 25,361 unique patients, of which 9482 (37.39%) had active portal accounts. The total dataset for radiologic imaging included 23,504 radiology studies on 14,455 unique patients, of which 5439 (37.63%) had an active portal account. Results Overall, 8.90% (18,573/208,635) of laboratory tests and 8.97% (2019/22,504) of radiology reports ordered in the ED were viewed in the patient portal. The highest rates of viewing of laboratory and radiology results were seen for those who were female, were aged 0 to 11 years (parent or guardian viewing by proxy) and 18 to 60 years, and self-reported their race as Caucasian or Asian. The lowest rates were for those who were teenagers, aged older than 81 years, African American/black, and Hispanic/Latino. Infectious disease, urinalysis, and pregnancy testing constituted the highest number of laboratory tests viewed. Magnetic resonance imaging reports were viewed at higher rates than computed tomography or x-ray studies ( P <.001). Approximately half of all the diagnostic test results accessed by patients were reviewed within 72 hours of availability in the patient portal (laboratory results: 9904/18,573, 53.32% and radiology reports: 971/2019, 48.1%). On the other extreme, 19.9% (3701/18,573) of laboratory results and 31.6% (639/2019) of radiology reports were viewed more than 2 weeks after availability in the portal. Conclusions The data highlight the relatively low use of a patient portal by ED patients and existing disparities between patient groups. There can be wide lag time (months) between result/report availability and access by patients. Opportunities for improvement exist for both activation and more robust utilization of patient portals by ED patients.

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Section: Discussionmentioning

confidence: 99%

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

Foster¹,

Krasowski²

2019

J Med Internet Res

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“…To obtain reliable information about toxicities that influence patient's quality of life, normal tissue toxicities are likely best represented by patient-reported outcomes (PROs) ( 7 ). Using clinical decision-support tools ( 8 , 9 ) and keeping the number of items/questions as few as possible ( 10 ) are necessary for actionability to patient-reported complaints. Dose-volume histogram (DVH) metrics of interest depend on a large variety of factors as pointed out within the 21 papers by the QUANTEC effort ( 11 ).…”

Section: Literature Resources For Outcome Modeling In Radiotherapymentioning

confidence: 99%

Registering Study Analysis Plans (SAPs) Before Dissecting Your Data—Updating and Standardizing Outcome Modeling

Thor

Apte

et al. 2020

Front. Oncol.

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Public preregistration of study analysis plans (SAPs) is widely recognized for clinical trials, but adopted to a much lesser extent in observational studies. Registration of SAPs prior to analysis is encouraged to not only increase transparency and exactness but also to avoid positive finding bias and better standardize outcome modeling. Efforts to generally standardize outcome modeling, which can be based on clinical trial and/or observational data, have recently spurred. We suggest a three-step SAP concept in which investigators are encouraged to (1) Design the SAP and circulate it among the co-investigators, (2) Log the SAP with a public repository, which recognizes the SAP with a digital object identifier (DOI), and (3) Cite (using the DOI), briefly summarize and motivate any deviations from the SAP in the associated manuscript. More specifically, the SAP should include the scope (brief data and study description, co-investigators, hypotheses, primary outcome measure, study title), in addition to step-by-step details of the analysis (handling of missing data, resampling, defined significance level, statistical function, validation, and variables and parameterization).

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“…Future EMR system designs could accommodate these differences by automatically adapting their functionality according to the particular needs and preferences of the healthcare receiver. By doing so, we would obtain person-centered EMR systems that fit the vision of person-centered healthcare systems [73,74].…”

Section: Emr System Design Implicationsmentioning

confidence: 99%

Understanding the EMR-Related Experiences of Pregnant Japanese Women to Redesign Antenatal Care EMR Systems

et al. 2019

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Woman-centered antenatal care necessitates Electronic Medical Record (EMR) systems that respect women’s preferences. However, women’s preferences regarding EMR systems in antenatal care remain unknown. This work aims to understand the EMR-related experiences that pregnant Japanese women want. First, we conducted a field-based observational study at an antenatal care clinic at a Japanese university hospital. We analyzed the data following a thematic analysis approach and found multiple EMR-related experiences that pregnant women encounter during antenatal care. Based on the observations’ findings, we administered a web survey to 413 recently pregnant Japanese women to understand their attitudes regarding the EMR-related experiences. Our results show that pregnant Japanese women want accessible, exchangeable, and biopsychosocial EMRs. They also want EMR-enabled explanations and summaries. Interestingly, differences in their demographics and stages of pregnancy affected their attitudes towards some EMR-related experiences. To respect their preferences, we propose amplifying the roles of EMR systems as tools that promote communication and woman-centeredness in antenatal care. We also propose expanding the EMR design mindset from a biomedical to a biopsychosocial-oriented one. Finally, to accommodate the differences in individual needs and preferences, we propose the design of adaptable person-centered EMR systems.

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Design and Development of a Person-Centered Patient Portal Using Participatory Stakeholder Co-Design

Cited by 77 publications

References 38 publications

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

Registering Study Analysis Plans (SAPs) Before Dissecting Your Data—Updating and Standardizing Outcome Modeling

Understanding the EMR-Related Experiences of Pregnant Japanese Women to Redesign Antenatal Care EMR Systems

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