Impact of Patient Portal Use on Duplicate Laboratory Tests in Diabetes Management

Wakefield, Bonnie J.; Turvey, Carolyn; Hogan, Timothy P.; Shimada, Stephanie L.; Nazi, Kim M.; Cao, Lishan; Stroupe, Kevin T.; Martínez, Rachael N.; Smith, Bridget

doi:10.1089/tmj.2019.0237

Cited by 11 publications

(8 citation statements)

References 37 publications

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“…In the updated search in August 2023, OP and WG independently screened titles and abstracts, followed by an independent review of the selected full texts, and disagreements were resolved by consensus. During this stage, 7 articles met the inclusion criteria [19,[44][45][46][47][48][49]. A list of articles compiled by OP during the ongoing monitoring of new publications from September 2020 to August 2023 was compared with the results of the updated search, and 2 new articles [50,51] meeting the inclusion criteria were added.…”

Section: Study Selectionmentioning

confidence: 99%

Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review

Petrovskaya,

Karpman,

Schilling

et al. 2023

J Med Internet Res

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Background A frequently used feature of electronic patient portals is the viewing of test results. Research on patient portals is abundant and offers evidence to help portal implementers make policy and practice decisions. In contrast, no comparable comprehensive summary of research addresses the direct release of and patient access to test results. Objective This scoping review aims to analyze and synthesize published research focused on patient and health care provider perspectives on the direct release of laboratory, imaging, and radiology results to patients via web portals. Methods PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Searches were conducted in CINAHL, MEDLINE, and other databases. Citations were screened in Covidence using the inclusion and exclusion criteria. Primary studies that focused on patient and health care provider perspectives on patient access to laboratory and imaging results via web portals were included. An updated search was conducted up to August 2023. Our review included 27 articles—20 examining patient views, 3 examining provider views, and 4 examining both patient and provider views. Data extraction and inductive data analysis were informed by sensitizing concepts from sociomaterial perspectives, and 15 themes were generated. Results Patient perspectives (24 papers) were synthesized using nine themes: (1) patterns of use and patient characteristics; (2) emotional response when viewing the results and uncertainty about their implications; (3) understanding test results; (4) preferences for mode and timing of result release; (5). information seeking and patients’ actions motivated by viewing results via a portal; (6) contemplating changes in behavior and managing own health; (7) benefits of accessing test results via a portal; (8) limitations of accessing test results via a portal; and (9) suggestions for portal improvement. Health care provider perspectives (7 papers) were synthetized into six themes: (1) providers’ view of benefits of patient access to results via the portal; (2) effects on health care provider workload; (3) concerns about patient anxiety; (4) timing of result release into the patient portal; (5) the method of result release into the patient portal: manual versus automatic release; and (6) the effects of hospital health information technology system on patient quality outcomes. Conclusions The timing of the release of test results emerged as a particularly important topic. In some countries, the policy context may motivate immediate release of most tests directly into patient portals. However, our findings aim to make policy makers, health administrators, and other stakeholders aware of factors to consider when making decisions about the timing of result release. This review is sensitive to the characteristics of patient populations and portal technology and can inform result release framework policies. The findings are timely, as patient portals have become more common internationally.

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Section: Study Selectionmentioning

confidence: 99%

Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review

Petrovskaya,

Karpman,

Schilling

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

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“…26 Last, a study of the Blue Button feature (n ¼ 3762 users, 26 424 nonusers) found that Blue Button users had lower odds of duplicate HbA1c testing compared with nonusers. 27 Studies outside the VHA have also found a relationship between portal use and positive health outcomes among patients with diabetes. Secure message intensity has been associated with better glycemic control and increased outpatient utilization.…”

Section: Introductionmentioning

confidence: 99%

Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration

Zocchi

Robinson

Ash

et al. 2021

Journal of the American Medical Informatics Association

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Objective The study sought to investigate whether consistent use of the Veterans Health Administration’s My HealtheVet (MHV) online patient portal is associated with improvement in diabetes-related physiological measures among new portal users. Materials and Methods We conducted a retrospective cohort study of new portal users with type 2 diabetes that registered for MHV between 2012 and 2016. We used random-effect linear regression models to examine associations between months of portal use in a year (consistency) and annual means of the physiological measures (hemoglobin A1c [HbA1c], low-density lipoproteins [LDLs], and blood pressure [BP]) in the first 3 years of portal use. Results For patients with uncontrolled HbA1c, LDL, or BP at baseline, more months of portal use in a year was associated with greater improvement. Compared with 1 month of use, using the portal 12 months in a year was associated with annual declines in HbA1c of -0.41% (95% confidence interval [CI], -0.46% to -0.36%) and in LDL of -6.25 (95% CI, -7.15 to -5.36) mg/dL. Twelve months of portal use was associated with minimal improvements in BP: systolic BP of -1.01 (95% CI, -1.33 to -0.68) mm Hg and diastolic BP of -0.67 (95% CI, -0.85 to -0.49) mm Hg. All associations were smaller or not present for patients in control of these measures at baseline. Conclusions We found consistent use of the patient portal among new portal users to be associated with modest improvements in mean HbA1c and LDL for patients at increased risk at baseline. For patients with type 2 diabetes, self-management supported by online patient portals may help control HbA1c, LDL, and BP.

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“…Comprehensive patient portals that enable access to data from multiple health services (ie, internal and external laboratories, diagnostic images, and discharge reports) have been shown to reduce duplicate testing [ 11 ] and enhance communication [ 12 , 13 ]. The primary argument for patient portals is not that they intend to create value for money; rather, they foster patient empowerment and self-management and improve patients’ engagement in their care [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Implementation Strategies to Improve Engagement With a Multi-Institutional Patient Portal: Multimethod Study

Fujioka

Bickford²,

Gritke

et al. 2021

J Med Internet Res

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Background Comprehensive multi-institutional patient portals that provide patients with web-based access to their data from across the health system have been shown to improve the provision of patient-centered and integrated care. However, several factors hinder the implementation of these portals. Although barriers and facilitators to patient portal adoption are well documented, there is a dearth of evidence examining how to effectively implement multi-institutional patient portals that transcend traditional boundaries and disparate systems. Objective This study aims to explore how the implementation approach of a multi-institutional patient portal impacted the adoption and use of the technology and to identify the lessons learned to guide the implementation of similar patient portal models. Methods This multimethod study included an analysis of quantitative and qualitative data collected during an evaluation of the multi-institutional MyChart patient portal that was deployed in Southwestern Ontario, Canada. Descriptive statistics were performed to understand the use patterns during the first 15 months of implementation (between August 2018 and October 2019). In addition, 42 qualitative semistructured interviews were conducted with 18 administrative stakeholders, 16 patients, 7 health care providers, and 1 informal caregiver to understand how the implementation approach influenced user experiences and to identify strategies for improvement. Qualitative data were analyzed using an inductive thematic analysis approach. Results Between August 2018 and October 2019, 15,271 registration emails were sent, with 67.01% (10,233/15,271) registered for an account across 38 health care sites. The median number of patients registered per site was 19, with considerable variation (range 1-2114). Of the total number of sites, 55% (21/38) had ≤30 registered patients, whereas only 2 sites had over 1000 registered patients. Interview participants perceived that the patient experience of the portal would have been improved by enhancing the data comprehensiveness of the technology. They also attributed the lack of enrollment to the absence of a broad rollout and marketing strategy across sites. Participants emphasized that provider engagement, change management support, and senior leadership endorsement were central to fostering uptake. Finally, many stated that regional alignment and policy support should have been sought to streamline implementation efforts across participating sites. Conclusions Without proper management and planning, multi-institutional portals can suffer from minimal adoption. Data comprehensiveness is the foundational component of these portals and requires aligned policies and a key base of technology infrastructure across all participating sites. It is important to look beyond the category of the technology (ie, patient portal) and consider its functionality (eg, data aggregation, appointment scheduling, messaging) to ensure that it aligns with the underlying strategic priorities of the deployment. It is also critical to establish a clear vision and ensure buy-ins from organizational leadership and health care providers to support a cultural shift that will enable a meaningful and widespread engagement.

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Impact of Patient Portal Use on Duplicate Laboratory Tests in Diabetes Management

Cited by 11 publications

References 37 publications

Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review

Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review

Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration

Implementation Strategies to Improve Engagement With a Multi-Institutional Patient Portal: Multimethod Study

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