Improving Patient-Provider Continuity in a Large Urban Academic Primary Care Network

Snyder, Dane; Schuller, Jonathon; Ameen, Zeenath; Toth, Christina; Kemper, Alex R.

doi:10.1016/j.acap.2021.11.005

Cited by 2 publications

(4 citation statements)

References 16 publications

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“…On average, each 1‐year increase in patient age was associated with 3% decreased odds of CAT‐MH® completion, consistent with previous literature showing older individuals face steeper challenges to digital health tools 26 including due to attitudes, acceptability, disability, knowledge/familiarity, access, and cost 26,27 . Increased telehealth and patient portal use during the COVID‐19 pandemic highlighted the importance of addressing age‐related inequity in technology‐based health interventions 28‐30 . Demonstrating usefulness, providing tutoring, and designing interfaces to accommodate visual, cognitive, and motor impairments may be needed to increase remote MBC uptake among older patients 26 .…”

Section: Discussionsupporting

confidence: 80%

“… 26 , 27 Increased telehealth and patient portal use during the COVID‐19 pandemic highlighted the importance of addressing age‐related inequity in technology‐based health interventions. 28 , 29 , 30 Demonstrating usefulness, providing tutoring, and designing interfaces to accommodate visual, cognitive, and motor impairments may be needed to increase remote MBC uptake among older patients. 26 In our study, persons with female sex listed in their EHR were more likely to complete CAT‐MH® than those with male listed sex, which was not significant after covariate adjustment.…”

Section: Discussionmentioning

confidence: 99%

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Determinants of remote measurement‐based care uptake in a safety net outpatient psychiatry department as part of learning health system transition

Aldis,

Rosenfeld,

Mulvaney‐Day

et al. 2024

Learning Health Systems

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IntroductionBehavioral measurement‐based care (MBC) can improve patient outcomes and has also been advanced as a critical learning health system (LHS) tool for identifying and mitigating potential disparities in mental health treatment. However, little is known about the uptake of remote behavioral MBC in safety net settings, or possible disparities occurring in remote MBC implementation.MethodsThis study uses electronic health record data to study variation in completion rates at the clinic and patient level of a remote MBC symptom measure tool during the first 6 months of implementation at three adult outpatient psychiatry clinics in a safety net health system. Provider‐reported barriers to MBC adoption were also measured using repeated surveys at one of the three sites.ResultsOut of 1219 patients who were sent an MBC measure request, uptake of completing at least one measure varied by clinic: General Adult Clinic, 38% (n = 262 of 696); Substance Use Clinic, 28% (n = 73 of 265); and Transitions Clinic, 17% (n = 44 of 258). Compared with White patients, Black and Portuguese or Brazilian patients had lower uptake. Older patients also had lower uptake. Spanish language of care was associated with much lower uptake at the patient level. Significant patient‐level disparities in uptake persisted after adjusting for the clinic, mental health diagnoses, and number of measure requests sent. Providers cited time within visits and bandwidth in their workflow as the greatest consistent barriers to discussing MBC results with patients.ConclusionsThere are significant disparities in MBC uptake at the patient and clinic level. From an LHS data infrastructure perspective, safety net health systems may need to address the need for possible ways to adapt MBC to better fit their populations and clinical needs, or identify targeted implementation strategies to close data gaps for the identified disparity populations.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Determinants of remote measurement‐based care uptake in a safety net outpatient psychiatry department as part of learning health system transition

Aldis,

Rosenfeld,

Mulvaney‐Day

et al. 2024

Learning Health Systems

View full text Add to dashboard Cite

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“…In particular, patient portals have been identified as a critical tool in supporting the continuity and access to care throughout the pandemic ( 8 ). For instance, accessing telehealth appointments through the portal, modifying scheduling guidelines to reduce in-person visits, and frequent messaging to increase awareness of new modes of access as COVID-19 regulations change and encourage scheduling appointments ( 8 , 9 ). In the context of COVID-19, patient portals allow patients to view their test and lab results, message their care providers with any concerns, book appointments and seek relevant patient education materials ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, while these platforms have become a key mechanism for supporting the management of the pandemic, there is a lack of evidence and data about the adoption and use of portals over the last 18 months in the Canadian setting. However, one case (9) in the United States reported that portal activation during the pandemic significantly increased from 18% in February 2020 to 44% in April 2021 at the Nationwide Children's Hospital Primary Care Network in Ohio and another reported an increase from 3,511 in January 2020 to 10,077 in May 2020 at UCHealth in Colorado (17). The forced shift in care models during the pandemic yields unique insights to inform how these solutions can be better positioned to support care delivery and better health outcomes during and beyond the pandemic (18,19).…”

Section: Introductionmentioning

confidence: 99%

Why are Patient Portals Important in the Age of COVID-19? Reflecting on Patient and Team Experiences From a Toronto Hospital Network

Charow

Laberge

et al. 2022

Journal of Patient Experience

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The COVID-19 pandemic has changed how care is being delivered in Canada. With conventional in-person care being transitioned to virtual care, the approach that patients are able to engage and access their care has dramatically changed. At the University Health Network (UHN), which is Canada's largest academic and teaching hospital network, we expanded the myUHN Patient Portal in 2017 after its early adopter phase to enable patients and family members to view parts of their clinical notes and test results. As the pandemic progressed, we observed high adoption of myUHN to support virtual care and rapid delivery of COVID-19 test results in real time. In this article, we share and reflect on our experience of adapting myUHN to support the demands of the pandemic, including portal adoption outcomes across multiple waves of the pandemic, the impetus for increased patient experience staff dedicated for myUHN support, and patients’ perceptions of the value of the portal and virtual care. Based on these reflections, we outline our perspectives on the future role of patient portals to support patient care and experience in a post-pandemic environment.

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Improving Patient-Provider Continuity in a Large Urban Academic Primary Care Network

Cited by 2 publications

References 16 publications

Determinants of remote measurement‐based care uptake in a safety net outpatient psychiatry department as part of learning health system transition

Determinants of remote measurement‐based care uptake in a safety net outpatient psychiatry department as part of learning health system transition

Why are Patient Portals Important in the Age of COVID-19? Reflecting on Patient and Team Experiences From a Toronto Hospital Network

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