Patient Portal Functionalities and Uptake: Systematic Review Protocol

Alturkistani, Abrar; Greenfield, Geva; Greaves, Felix; Aliabadi, Shirin; Jenkins, Rosemary; Costelloe, Céire

doi:10.2196/14975

Cited by 12 publications

(12 citation statements)

References 36 publications

(47 reference statements)

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“…This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 17 ] ( Multimedia Appendix 1 ). The protocol of the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42019141131) and was published in JMIR Research Protocols (RR1-10.2196/14975) [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…The population included adult patients with diabetes aged 18 years or older. The initial intent in the review protocol [ 18 ] was to include all adult patient portal users, without focusing on patients with a specific disease. However, owing to the large number of studies reporting patient portal–related health outcomes and the diversity of the patient populations studied, we decided to focus on patients with diabetes only.…”

Section: Methodsmentioning

confidence: 99%

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Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

Alturkistani¹,

Qavi²,

Anyanwu³

et al. 2020

J Med Internet Res

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Background Patient portal use could help improve the care and health outcomes of patients with diabetes owing to functionalities, such as appointment booking, electronic messaging (e-messaging), and repeat prescription ordering, which enable patient-centered care and improve patient self-management of the disease. Objective This review aimed to summarize the evidence regarding patient portal use (portals that are connected to electronic health care records) or patient portal functionality use (eg, appointment booking and e-messaging) and their reported associations with health and health care quality outcomes among adult patients with diabetes. Methods We searched the MEDLINE, Embase, and Scopus databases and reported the review methodology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent reviewers screened titles and abstracts, and two reviewers assessed the full texts of relevant studies and performed data extraction and quality assessments of the included studies. We used the Cochrane Collaboration Risk of Bias Tool and the National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool to assess the risk of bias of the included studies. Data were summarized through narrative synthesis. Results Twelve studies were included in this review. Five studies reported overall patient portal use and its association with diabetes health and health care quality outcomes. Six studies reported e-messaging or email use–associated outcomes, and two studies reported prescription refill–associated outcomes. The reported health outcomes included the associations of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI. Few studies reported health care utilization outcomes such as office visits, emergency department visits, and hospitalizations. A limited number of studies reported overall quality of care for patients with diabetes who used patient portals. Conclusions The included studies mostly reported improved glycemic control outcomes for patients with diabetes who used patient portals. However, limitations of studying the effects of patient portals exist, which do not guarantee whether the outcomes reported are completely the result of patient portal use or if confounding factors exist. Randomized controlled trials and mixed-methods studies could help understand the mechanisms involved in health outcome improvements and patient portal use among patients with diabetes. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141131. International Registered Report Identifier (IRRID) RR2-10.2196/14975

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

Alturkistani¹,

Qavi²,

Anyanwu³

et al. 2020

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…4 Besides EHR access, a patient portal may also offer additional functionalities 5 such as access to test and laboratory result, viewing visit notes, requesting medication refills, appointment scheduling, or secure messaging with the health provider. [5][6][7][8] Patient portals are considered a health information technology that promotes patient engagement by providing tools to become active participants in one's own care. [9][10][11] Patient engagement has received considerable attention in recent years, 10 and patient portals may contribute to engaging the patients actively in their care by granting them access to their health data and providing additional functionalities.…”

Section: Introductionmentioning

confidence: 99%

“…7,[12][13][14] To date, we find a very heterogeneous landscape and a broad diversity of patient portals 15 regarding their intended deployment and functionalities. 8,16 Patient portals can be projected for specific care sectors, for example, primary or secondary care based on each care sector's different needs. They may also follow an approach not specific for a sector.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Useful Taxonomy of Patient Portals Based on Characteristics of Patient Engagement

Glöggler

Ammenwerth

2021

Methods Inf Med

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Objective Taxonomies are classification systems used to reduce complexity and better understand a domain. The present research aims to develop a useful taxonomy for health information managers to classify and compare patient portals based on characteristics appropriate to promote patient engagement. As a result, the taxonomy should contribute to understanding the differences and similarities of the portals. Further, the taxonomy shall support health information managers to more easily define which general type and functionalities of patient portals they need and to select the most suitable solution offered on the market. Methods We followed the formal taxonomy-building method proposed by Nickerson et al. Based on a literature review, we created a preliminary taxonomy following the conceptional approach of the model. We then evaluated each taxa's appropriateness by analyzing and classifying 17 patient portals offered by software vendors and 11 patient portals offered by health care providers. After each iteration, we examined the achievement of the determined objective and subjective ending conditions. Results After two conceptional approaches to create our taxonomy, and two empirical approaches to evaluate it, the final taxonomy consists of 20 dimensions and 49 characteristics. To make the taxonomy easy to comprehend, we assigned to the dimensions seven aspects related to patient engagement. These aspects are (1) portal design, (2) management, (3) communication, (4) instruction, (5) self-management, (6) self-determination, and (7) data management. The taxonomy is considered finished and useful after all ending conditions that defined beforehand have been fulfilled. We demonstrated that the taxonomy serves to understand the differences and similarities by comparing patient portals. We call our taxonomy “Taxonomy of Patient Portals based on Characteristics of Patient Engagement (TOPCOP).” Conclusion We developed the first useful taxonomy for health information managers to classify and compare patient portals. The taxonomy is based on characteristics promoting patient engagement. With 20 dimensions and 49 characteristics, our taxonomy is particularly suitable to discriminate among patient portals and can easily be applied to compare portals. The TOPCOP taxonomy enables health information managers to better understand the differences and similarities of patient portals. Further, the taxonomy may help them to define the type and general functionalities needed. But it also supports them in searching and comparing patient portals offered on the market to select the most suitable solution.

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“…Patient portals have a wide array of functionalities of potential relevance in a disaster scenario, including secure messaging between patients and health care providers; access to medical records, test results, and education resources; and medication refills [22][23][24]. In addition, portal access is often a prerequisite to being able to schedule and attend telehealth visits, which have increased significantly since the COVID-19 pandemic struck [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey

Baek¹,

Simon-Friedt²,

López³

et al. 2021

J Med Internet Res

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Background Patient portals play an important role in connecting patients with their medical care team, which improves patient engagement in treatment plans, decreases unnecessary visits, and reduces costs. During natural disasters, patients’ needs increase, whereas available resources, specifically access to care, become limited. Objective This study aims to examine patients’ health needs during a natural crisis by analyzing the electronic messages sent during Hurricane Harvey to guide future disaster planning efforts. Methods We explored patient portal use data from a large Greater Houston area health care system focusing on the initial week of the Hurricane Harvey disaster, beginning with the date of landfall, August 25, 2017, to August 31, 2017. A mixed methods approach was used to assess patients’ immediate health needs and concerns during the disruption of access to routine and emergent medical care. Quantitative analysis used logistic regression models to assess the predictive characteristics of patients using the portal during Hurricane Harvey. This study also included encounters by type (emergency, inpatient, observation, outpatient, and outpatient surgery) and time (before, during, and after Hurricane Harvey). For qualitative analysis, the content of these messages was examined using the constant comparative method to identify emerging themes found within the message texts. Results Out of a total of 557,024 patients, 4079 (0.73%) sent a message during Hurricane Harvey, whereas 31,737 (5.69%) used the portal. Age, sex, race, and ethnicity were predictive factors for using the portal and sending a message during the natural disaster. We found that prior use of the patient portal increased the likelihood of portal use during Hurricane Harvey (odds ratio 13.688, 95% CI 12.929-14.491) and of sending a portal message during the disaster (odds ratio 14.172, 95% CI 11.879-16.907). Having an encounter 4 weeks before or after Hurricane Harvey was positively associated with increased use of the portal and sending a portal message. Patients with encounters during the main Hurricane Harvey week had a higher increased likelihood of portal use across all five encounter types. Qualitative themes included: access, prescription requests, medical advice (chronic conditions, acute care, urgent needs, and Hurricane Harvey–related injuries), mental health, technical difficulties, and provider constraints. Conclusions The patient portal can be a useful tool for communication between patients and providers to address the urgent needs and concerns of patients as a natural disaster unfolds. This was the first known study to include encounter data to understand portal use compared with care provisioning. Prior use was predictive of both portal use and message sending during Hurricane Harvey. These findings could inform the types of demands that may arise in future disaster situations and can serve as the first step in intentionally optimizing patient portal usability for emergency health care management during natural disasters.

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Patient Portal Functionalities and Uptake: Systematic Review Protocol

Cited by 12 publications

References 36 publications

Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

Development and Validation of a Useful Taxonomy of Patient Portals Based on Characteristics of Patient Engagement

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey

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