Patient Engagement Functionalities in U.S. Hospitals

Asagbra, O. Elijah; Zengul, Ferhat; Burke, Darrell

doi:10.1097/jhm-d-18-00095

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…A hospital's performance depends on resources such as the degree of EHR system implementation as well as the breadth and depth of patient engagement functionalities. The effect of patient engagement functionalities on quality outcomes has been studied and found to be negatively associated with readmission rates (Asagbra et al, 2019).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

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Patient Engagement Functionalities’ Influence on Quality Outcomes: The Road via EHR Presence

Upadhyay,

Bhandari

2024

Journal of Healthcare Management

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SUMMARY Goal: Patients engaged in self-care through information technology can potentially improve the quality of healthcare they receive. This study aimed to examine how electronic health record (EHR) system functionalities help hospitals mediate the impact of patient engagement on quality outcomes—notably, readmission rates. Methods: A pooled cross-sectional study design employed data containing 3,547 observations from general acute care hospitals (2014–2018). The breadth of patient engagement functionalities adopted by a hospital was used as the independent variable and the degree of EHR presence was used as the mediating variable. Mean time to readmission for acute myocardial infarction (AMI), pneumonia, and heart failure were the dependent variables. The Baron and Kenny method was used to test mediation. Principal Findings: Patient engagement was associated with reduced AMI readmission rates both directly and via EHR system presence. Mediation effects were present, in that a 1-unit increase in patient engagement through EHR system presence was associated with a 0.33% decrease in AMI readmission rates (p < .05). For other disease categories (heart failure and pneumonia), a significant effect was not found. Practical Applications: For hospitals with a comprehensive EHR system, patient engagement through information technology can potentially reduce readmission rates for some diseases. More research is needed to determine which specific clinical conditions are amenable to quality improvement through patient engagement. Synergies between patient engagement functionalities and an EHR system positively affect quality outcomes. Therefore, practitioners and hospital managers should leverage hospital investments made in their EHR system infrastructure and use it to engage patients in self-care.

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Section: Conceptual Frameworkmentioning

confidence: 99%

“…There is evidence that such integration improves some quality outcomes. Indeed, a higher number of patient engagement functionalities is associated with lower readmission rates (Asagbra et al, 2019). However, there is limited research into factors that mediate the potential impact of patient engagement on hospital readmission rates.…”

Section: Introductionmentioning

confidence: 99%

Patient Engagement Functionalities’ Influence on Quality Outcomes: The Road via EHR Presence

Upadhyay,

Bhandari

2024

Journal of Healthcare Management

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confidence: 99%

“…Patient engagement is defined as actions that promote and support active patient involvement in their health and the health care delivery process 9,10. To fulfill the meaningful use requirements, patients must be able to view, download, and transmit information using the health IT functionalities 9,11. Patient engagement functionalities (eg, scheduling appointments, refilling prescriptions, and developing personalized interventions) can enable information transfer and acquisition, decision making, patient-provider communication, and symptom monitoring 9,12,13…”

mentioning

confidence: 99%

“…9,11 Patient engagement functionalities (eg, scheduling appointments, refilling prescriptions, and developing personalized interventions) can enable information transfer and acquisition, decision making, patient-provider communication, and symptom monitoring. 9,12,13 Prior research indicates that various resource and technical barriers have restricted the patient engagement capabilities of EHRs. 3,14,15 In the context of hospitals, Walker et al 13 examined the relationship between hospital capabilities based on their characteristics and their patient engagement IT scores and found a wide variation in the level of adoption.…”

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confidence: 99%

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Do Patient Engagement IT Functionalities Influence Patient Safety Outcomes? A Study of US Hospitals

Upadhyay

Opoku-Agyeman

Choi

et al. 2022

Journal of Public Health Management and Practice

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Objective: Patient engagement using health information technology (IT) functionalities can be a powerful tool in managing their own care for better health outcomes. Therefore, this study explores whether patient engagement IT functionalities and electronic health record (EHR) can affect patient safety outcomes. Design: Using longitudinal study design for general acute care hospitals within the United States, we examine the interaction effects of EHR and patient engagement IT functionalities on patient safety outcomes (adverse incident rate) using a generalized estimating equation. Setting: Our national sample consisted of 9759 hospital-year observations from 2014 to 2018. Overall, we found a significant association between adverse incident rate and patient engagement level and EHR adoption level. Results: On average, as the combined effects of patient engagement level and EHR adoption level increases, the adverse incident rate decreases by approximately 0.49 (P < .01). Incorporating patient engagement functionalities is becoming an essential tool to improve health outcomes and will play an instrumental role in meeting meaningful use standards. Conclusions:Our study provides insights into the potential synergy between a hospital's existing EHR maturity and patient engagement health IT functionalities in affecting organizational performance. Organizational culture and capabilities pertinent to adopting patient engagement health IT functionalities infrastructure should be established first to provide the impetus for this synergy.

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An Assessment of Patient Portal Messaging Use by Patients With Multiple Chronic Conditions Living in Rural Communities: Retrospective Analysis

Chivela¹,

Burch²,

Asagbra³

2023

J Med Internet Res

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Background Patient portals can facilitate the delivery of health care services and support self-management for patients with multiple chronic conditions. Despite their benefits, the evidence of patient portal use among patients with multimorbidity in rural communities is limited. Objective This study aimed to explore the factors associated with portal messaging use by rural patients. Methods We assessed patient portal use among patients with ≥1 chronic diagnoses who sent or received messages via the Epic MyChart (Epic Systems Corporation) portal between January 1, 2015, and November 9, 2021. Patient portal use was defined as sending or receiving a message through the portal during the study period. We fit a zero-inflated negative binomial model to predict portal use based on the patient’s number of chronic conditions, sex, race, age, marital status, and insurance type. County-level characteristics, based on the patient’s home address, were also included in the model to assess the influence of community factors on portal use. County-level factors included educational attainment, smartphone ownership, median income, and primary care provider density. Results A total of 65,178 patients (n=38,587, 59.2% female and n=21,454, 32.92% Black) were included in the final data set, of which 38,380 (58.88%) sent at least 1 message via the portal during the 7-year study period. As the number of chronic diagnoses increased, so did portal messaging use; however, this relationship was driven primarily by younger patients. Patients with 2 chronic conditions were 1.57 times more likely to send messages via the portal than those with 1 chronic condition (P<.001). In comparison, patients with ≥7 chronic conditions were approximately 11 times more likely to send messages than patients with 1 chronic condition (P<.001). A robustness check confirmed the interaction effect of age and the number of diagnoses on portal messaging. In the model including only patients aged <65 years, there was a significant effect of increased portal messaging corresponding to the number of chronic conditions (P<.001). Conversely, this relationship was not significant for the model consisting of older patients. Other significant factors associated with increased portal use include being female; White; married; having private insurance; and living in an area with a higher average level of educational attainment, greater medical provider density, and a lower median income. Conclusions Patients’ use of the portal to send messages to providers was incrementally related to their number of diagnoses. As the number of chronic diagnoses increased, so did portal messaging use. Patients of all ages, particularly those living in rural areas, could benefit from the convenience and cost-effectiveness of portal communication. Health care systems and providers are encouraged to increase the use of patient portals by implementing educational interventions to promote the advantages of portal communication, particularly among patients with multimorbidity.

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Patient Engagement Functionalities in U.S. Hospitals

Cited by 5 publications

References 32 publications

Patient Engagement Functionalities’ Influence on Quality Outcomes: The Road via EHR Presence

Patient Engagement Functionalities’ Influence on Quality Outcomes: The Road via EHR Presence

Do Patient Engagement IT Functionalities Influence Patient Safety Outcomes? A Study of US Hospitals

An Assessment of Patient Portal Messaging Use by Patients With Multiple Chronic Conditions Living in Rural Communities: Retrospective Analysis

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