Exploration of Portal Activation by Patients in a Healthcare System

Mook, Patricia; Trickey, Amber W.; Krakowski, Kimberly Ellis; Majors, Season; Theiss, Mary Anne; Fant, Catherine; Friesen, Mary Ann

doi:10.1097/cin.0000000000000392

Cited by 19 publications

(16 citation statements)

References 21 publications

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“…33 Our study reinforces others studies that show patient portal activation and utilization are lowest among underrepresented minorities. [34][35][36] In a previous study, we showed that patient portal access of diagnostic test data were much higher in outpatient versus inpatient or emergency department encounters. 22 However, the present data show that subgroups are utilizing the functionality of accessing the patient portal for outpatient diagnostic tests results at lower rates, driven in large part by lower patient portal account activation rates.…”

Section: Discussionmentioning

confidence: 99%

Activation and Utilization of an Electronic Health Record Patient Portal at an Academic Medical Center—Impact of Patient Demographics and Geographic Location

2018

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The advent of the online electronic health record patient portal has provided an efficient and practical means for patients to become more involved in their health care. In this report, we analyze how demographic variables such as age, gender, race, and geographic location affect patient portal activation and usage at the University of Iowa Hospitals and Clinics, the sole academic medical center in the state of Iowa, a predominantly rural state. Our primary end points were activation of the patient portal (MyChart, Epic, Inc) and access of outpatient laboratory and radiology results, among the most commonly accessed and popular features of the patient portal. We thus analyzed data from 536 378 patients to determine rates of patient portal activation and data from 219 671 patient encounters to determine the frequency at which patients access their online diagnostic test results. Higher rates of patient portal activation and usage were associated with female gender, Caucasians/non-underrepresented minorities, geographic location in closer proximity to the medical center (Iowa City and neighboring cities/suburbs), and nonelderly adults. For underrepresented minority and rural patients, opportunities for improvement exist for both activation and more robust use of online patient portal accounts. Overall, these data highlight existing disparities with online patient portal usage and provide a base on which further studies and interventions can help to improve utilization of these systems.

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Section: Discussionmentioning

confidence: 99%

Activation and Utilization of an Electronic Health Record Patient Portal at an Academic Medical Center—Impact of Patient Demographics and Geographic Location

2018

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“…4,5 Patient portals have primarily been used to share information with patients in the ambulatory setting. [5][6][7][8] The use of patient portals in the inpatient setting is a more recent phenomenon. These "inpatient portals" provide hospitalized patients with access to information from their inpatient EHR and a way to recognize and communicate with their inpatient clinicians.…”

Section: Background and Significancementioning

confidence: 99%

“…Patient portals have the potential to engage parents of hospitalized children and may play a role in improving the safety and quality of inpatient care. [7][8][9] Several studies have shown that, although physicians may have some concerns about the inpatient portal implementation, 21,22 generally patients are very satisfied. 9 However, few studies have examined nurses' expectations about inpatient portal implementation.…”

Section: Clinical Relevance Statementmentioning

confidence: 99%

Nurses' Expectations of an Inpatient Portal for Hospitalized Patients and Caregivers

et al. 2019

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Background Patient portals are intended to engage patients and enhance patient-centered care. Recent studies suggest that the information within portals could provide benefits to patients and their caregivers during hospitalization; however, few studies have examined nurse and staff expectations of portals when used in the hospital setting. Objective This article examines inpatient nurse and support staff expectations of a commercially available inpatient portal prior to its hospital-wide implementation. Methods In this cross-sectional study, nurses and support staff were surveyed 1 month prior to the implementation of an inpatient portal for patients. Items included respondent characteristics, satisfaction with online inpatient portal training, expectations of the effects of portal use on patients, caregivers, and staff, overall acceptance, and barriers to its implementation. Results Of 881 respondents, 73.0% were staff nurses, 18.4% nurse assistants, 4.3% unit coordinators, and 1.2% nurse managers. Respondents were generally satisfied with the portal information they received from online training. A majority liked the portal to some extent prior to its use (66.7%); however, they noted multiple implementation barriers, including: tablets would get lost/damaged (66.2% of respondents), patients and/or caregivers would have too many questions (48.5%), and staff would have problems integrating it into their workflow (44.7%). Respondents working on medical units had higher expectations (p < 0.001) and acceptance (p < 0.01) of the portal than those on surgical and intensive care units. Nurse managers were more positive than respondents with other job roles were (all p < 0.001). Conclusion Overall, nurse and support staff had high expectations of the effects of inpatient portal use prior to its hospital-wide implementation. They thought it would benefit patients and/or their caregivers; however, they also perceived several barriers to its implementation. These results will be used in conjunction with patient and caregiver perspectives to inform future efforts to evaluate and improve upon inpatient portal implementation and dissemination across health systems.

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“…More advanced functions such as secure messaging, access to educational resources, and the ability for the patient to enter data directly into the EHR are becoming more widely available. Recent empirical studies on patient portals have focused mainly on specific aspects of use (eg, use of specific functions such as secure messaging) and user characteristics, and almost all of these studies have been conducted in primary care and specialty clinics [13]. Although these studies hold promise for engaging patients in acute and outpatient settings, little is known about the use of patient-facing technologies, such as patient portals, by nursing home residents and their family members.…”

Section: Introductionmentioning

confidence: 99%

A National Assessment of Access to Technology Among Nursing Home Residents: A Secondary Analysis

Powell¹,

Alexander²,

Madsen³

et al. 2019

JMIR Aging

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Background According to the National Center for Health Statistics, there are over 1.7 million nursing home residents in the United States. Nursing home residents and their family members have unique needs and stand to benefit from using technology empowering them to be more informed and engaged health care consumers. Although there is growing evidence for benefits of patient-facing technologies like electronic patient portals on patient engagement in acute and outpatient settings, little is known about use of this technology in nursing homes. Objective The purpose of this study was to report findings from a secondary analysis of data from a national nursing home study of information technology (IT) adoption, called IT sophistication. We describe the extent to which nursing homes (n=815) allow residents or their representatives to access technology including electronic health records, patient portals, and health information-exchange systems as well as the ability of the residents or representatives to self-report data directly into the electronic health record. Methods We used descriptive statistics and regression techniques to explore relationships between information technology adoption (IT sophistication) and residents’ or their representatives’ access to technology. Covariates of location, bed size, and ownership were added to the model to understand their potential influence on the relationship between IT sophistication and resident access to technology. Results Findings revealed that resident access to technology was a significant predictor of the nursing home IT sophistication ( P <.001). The inclusion of covariates—nursing home location, bed size, and ownership—with their interactions produced a nonsignificant effect in the model. Residents’ or their representatives’ use of electronic health records and personal health records were both significant predictors of overall IT sophistication ( P <.001). Conclusions As nursing homes continue to progress in technological capabilities, it is important to understand how increasing IT sophistication can be leveraged to create opportunities to engage residents in their care. Understanding the impact of health information technology on outcomes and which technologies make a difference will help nursing home administrators make more informed decisions about adoption and implementation.

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Exploration of Portal Activation by Patients in a Healthcare System

Cited by 19 publications

References 21 publications

Activation and Utilization of an Electronic Health Record Patient Portal at an Academic Medical Center—Impact of Patient Demographics and Geographic Location

Activation and Utilization of an Electronic Health Record Patient Portal at an Academic Medical Center—Impact of Patient Demographics and Geographic Location

Nurses' Expectations of an Inpatient Portal for Hospitalized Patients and Caregivers

A National Assessment of Access to Technology Among Nursing Home Residents: A Secondary Analysis

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