Improving Diabetes Management With a Patient Portal: A Qualitative Study of Diabetes Self-Management Portal

Abstract

BackgroundEffective management and care of diabetes is crucial to reducing associated risks such as heart disease and kidney failure. With increasing access and use of the Internet, online chronic disease management is being explored as a means of providing patients with support and the necessary tools to monitor and manage their disease.ObjectiveThe objective of our study was to evaluate the experience of patients and providers using an online diabetes management portal for patients.MethodsParticipants were recruited from a large sample population of 887 for a follow-up questionnaire to be completed after 6 months of using the patient portal. Participants were presented with the option to participate in an additional interview and, if the participant agreed, a time and date was scheduled for the interview. A 5-item, open-ended questionnaire was used to capture providers' opinions of the patient portal. Providers included general practitioners (GPs), nurses, nurse practitioners (NPs), dieticians, diabetes educators (DECs), and other clinical staff.ResultsA total of 854 patients were consented for the questionnaire. Seventeen (8 male, 9 female) patients agreed to participate in a telephone interview. Sixty-four health care providers completed the five open-ended questions; however, an average of 48.2 responses were recorded per question. Four major themes were identified and will be discussed in this paper. These themes have been classified as: facilitators of disease management, barriers to portal use, patient-provider communication and relationship, and recommendations for portal improvements.ConclusionsThis qualitative study shows that online chronic disease management portals increase patient access to information and engagement in their health care, but improvements in the portal itself may improve usability and reduce attrition. Furthermore, this study identifies a grey area that exists in the roles that GPs and AHPs should play in the facilitation of online disease management.

Desafios para o cuidado da insuficiência cardíaca: pesquisa exploratória com enfermeiras em Ontario Challenges for the heart failure care: exploratory research with nurses in Ontario

“…17 For other strategies, such as the use of movies, its use was low, as well as telephone contact, which has shown efficacy in reducing hospitalizations for heart failure. [18][19] Internet use was considered very low, which as a strategy for health education, has been facing barriers to patient adherence 20 , but is considered a promising tool for the future. 21 The nurses identified the prevention of heart failure and its decompensation as a major challenge, which constitutes important purposes of health education.…”

In pursuit of integrated care: the contribution of patient portals (Preprint)

“…Five articles [23,24,27,29,31] described an item that could be related to cluster 4, mentioning it five times. Elements 3 and 5 of this cluster assert that involving client representatives in the care chain for monitoring or improving patient care helps to enhance the quality of integrated care.…”

“…Interprofessional teamwork is mentioned in just three articles [23,27,41], with one mention each. These studies describe how patient portals were deployed within a multi-disciplinary team.…”

“…Two articles [23,30] included items that relate to this cluster, with a total of two mentions. One study [30] states that "as a rule, messages that are communicated within the [Health and Welfare Information Portal] ZWIP are visible for all professionals with access to the ZWIP as well as for the frail older person and informal caregiver."…”

“…In just five studies [23,24,26,33,36] were we able to find negative impacts of patient portals on the following clusters: patientcenteredness (6 mentions), delivery system (4 mentions), performance management (1 mention) and interpersonal teamwork (1 mention) (see Table 5). …”