Meaningful Use of a Confidential Adolescent Patient Portal

Abstract

Institutional decisions for implementing meaningful use requirements can align with goals of adolescent health. Patient portals can enhance adolescent health care quality and adolescents readily use a confidential portal. Implementation of meaningful use requirements should be checked against adolescent health care needs to maximize confidentiality and promote health communication.

Long-term Patterns of Patient Portal Use for Pediatric Patients at an Academic Medical Center

“…Although adolescent patients are eligible for their own MHAV accounts at VUMC, over 83% of the logins for these patients were by done by surrogate users. In contrast, another study of a patient portal specifically designed for adolescent health care needs in the primary care setting saw frequent access by adolescent users [30]. In our study, the number of "self " logins for teenage users increased with the patient age, which could be attributed to adolescent patients becoming more involved in their care as they mature, being promoted by providers as recommended by the AAP, or becoming simply more familiar with using MHAV.…”

“…Differences in adolescent usage can be attributed in part to the institutional privacy and confidentiality policies. At VUMC, our approach favors parental access to a children's information whereas portals that prioritize adolescent confidentiality, allowing parents only limited information, show higher rates of adolescent usage [30]. One organization that required adolescent assent for proxy access showed low rates of registration for such accounts, suggesting that adolescents may have reservations about sharing their health data with their parents [32].…”

“…The American Academy of Pediatrics (AAP) developed an algorithm that urges providers to improve the transition period by encouraging adolescents to take a more active role in disease self-management and health maintenance through increased interaction with the healthcare system [51]. Few studies have explored independent use of patient portals by adolescent patients [30][31][32]. Although adolescent patients are eligible for their own MHAV accounts at VUMC, over 83% of the logins for these patients were by done by surrogate users.…”

“…A recent review of pediatric patient portals revealed only eleven studies [23], with the majority reporting qualitative studies on small populations assessing willingness to use patient portals, eliciting design recommendations, and conducting usability testing [24][25][26][27][28][29]. Three studies in pediatric primary care demonstrated relatively low uptake and reported usage disparities previously noted among adult populations [30][31][32]. Several studies have described usage by the pediatric patients with selected chronic diseases or their parents [33][34], with only one providing data about portal usage over time [35].…”

Providing Access: Differences in Pediatric Portal Activation Begin at Patient Check-in

“…Although Irizarry et al reported pediatric caregivers have the most interest in portals, there are few studies or systematic reviews examining pediatric portals. 9,22,[25][26][27] Objectives This study examined patterns of patient portal codes and activation at two tertiary academic pediatric hospitals, one in Colorado and the other in Southern California, by race/ ethnicity, preferred language, patient gender, and activation by caregiver proxy or adolescent patient. One site had both English and Spanish portal information and activation materials and the other provided English-only access.…”