Patient Portal Use Among Older Adults With Dementia Diagnosis

Gleason, Kelly; Wu, Mei‐Hwan; Wec, Aleksandra; Powell, Danielle; Zhang, Talan; Wolff, Jennifer L.

doi:10.1001/jamainternmed.2023.1568

Cited by 6 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Encouragement from healthcare providers and user-friendly designs from vendors are essential. [36][37][38] Nonetheless, the increasing use of portals may lead to clinician burnout, [39,40] underscoring the need for strategies that balance efficient digital interaction management with healthcare team well-being. Achieving this equilibrium is crucial for maximizing patient satisfaction and the effective use of digital health tools.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Patient Portal Engagement Associated with Improved Weight Loss Outcomes in Post-Bariatric Surgery Patients

Zhang,

Kang,

Yan

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Bariatric surgery is an effective intervention for obesity, but it requires comprehensive postoperative self-management to achieve optimal outcomes. While patient portals are generally seen as beneficial in engaging patients in health management, the link between their use and post-bariatric surgery weight loss remains unclear. Objective: This study investigated the association between patient portal engagement and postoperative body mass index (BMI) reduction among bariatric surgery patients. Methods: This retrospective longitudinal study included patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at Vanderbilt University Medical Center (VUMC) between January 2018 and March 2021. Using generalized estimating equations, we estimated the association between active days of postoperative patient portal use and the reduction of BMI percentage (%BMI) at 3, 6, and 12 months post-surgery. Covariates included duration since surgery, the patient′s age at the time of surgery, gender, race and ethnicity, type of bariatric surgery, severity of comorbid conditions, and socioeconomic disadvantage. Results: The study included 1,415 patients, mostly female (80.9%), with diverse racial and ethnic backgrounds. 805 (56.9%) patients underwent RYGB and 610 (43.1%) underwent SG. By one-year post-surgery, the mean (SD) %BMI reduction was 31.1% (8.3%), and the mean (SD) number of patient portal active days was 61.0 (41.2). A significantly positive association was observed between patient portal engagement and %BMI reduction, with variations revealed over time. Each 10-day increment of active portal use was associated with a 0.57% ([95% CI: 0.42- 0.72],P< .001) and 0.35% ([95% CI: 0.22- 0.49],P< .001) %BMI reduction at 3 and 6 months postoperatively. The association was not statistically significant at 12 months postoperatively (β=-0.07, [95% CI: -0.24- 0.09],P= .54). Various portal functions, including messaging, visits, my record, medical tools, billing, resources, and others, were positively associated with %BMI reduction at 3- and 6-months follow-ups. Conclusions: Greater patient portal engagement, which may represent stronger adherence to postoperative instructions, better self-management of health, and enhanced communication with care teams, was associated with improved postoperative weight loss. Future investigations are needed to identify important portal features that contribute to the long-term success of weight loss management.

show abstract

Section: Discussionmentioning

confidence: 99%

Enhanced Patient Portal Engagement Associated with Improved Weight Loss Outcomes in Post-Bariatric Surgery Patients

Zhang,

Kang,

Yan

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“… 34–36 The prevailing belief has been that more vulnerable subpopulations are less likely to be patient portal users 3 , 37 ; yet, emerging evidence suggests otherwise. 6 Moreover, persons with complex health needs and disabilities may benefit from being able to access care virtually, 38 , 39 without the complexity and additional time involved in traveling to an in-person visit. 39 , 40 As both patients and care partners look to clinicians for support and referrals in the context of serious illness, portal-based applications could have a range of benefits beyond those that have been targeted to date by assisting care partners as well as targeting a range of outcomes that pertain to care experiences and efficiency.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Emerging evidence indicates that registration and use of the patient portal by patients and their care partners are high, even among older adults and those with serious illnesses such as dementia. 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Patient portal interventions: a scoping review of functionality, automation used, and therapeutic elements of patient portal interventions

Gleason,

Powell,

Wec

et al. 2023

JAMIA Open

Self Cite

View full text Add to dashboard Cite

Objectives We sought to understand the objectives, targeted populations, therapeutic elements, and delivery characteristics of patient portal interventions. Materials and Methods Following Arksey and O-Malley’s methodological framework, we conducted a scoping review of manuscripts published through June 2022 by hand and systematically searching PubMed, PSYCHInfo, Embase, and Web of Science. The search yielded 5403 manuscripts; 248 were selected for full-text review; 81 met the eligibility criteria for examining outcomes of a patient portal intervention. Results The 81 articles described: trials involving comparison groups (n = 37; 45.7%), quality improvement initiatives (n = 15; 18.5%), pilot studies (n = 7; 8.6%), and single-arm studies (n = 22; 27.2%). Studies were conducted in primary care (n = 33, 40.7%), specialty outpatient (n = 24, 29.6%), or inpatient settings (n = 4, 4.9%)—or they were deployed system wide (n = 9, 11.1%). Interventions targeted specific health conditions (n = 35, 43.2%), promoted preventive services (n = 19, 23.5%), or addressed communication (n = 19, 23.4%); few specifically sought to improve the patient experience (n = 3, 3.7%). About half of the studies (n = 40, 49.4%) relied on human involvement, and about half involved personalized (vs exclusively standardized) elements (n = 42, 51.8%). Interventions commonly collected patient-reported information (n = 36, 44.4%), provided education (n = 35, 43.2%), or deployed preventive service reminders (n = 14, 17.3%). Discussion This scoping review finds that most patient portal interventions have delivered education or facilitated collection of patient-reported information. Few interventions have involved pragmatic designs or been deployed system wide. Conclusion The patient portal is an important tool in real-world efforts to more effectively support patients, but interventions to date rely largely on evidence from consented participants rather than pragmatically implemented systems-level initiatives.

show abstract

“…We constructed a Portal Activity Metric, defined as the ratio of logins (either patient or care partner with "shared access" credentials, in the numerator) to clinical visits incurred by the patient for a specified observation period (in the denominator), as described previously. 24 We differentiated a Patient-Portal Activity Metric, which captured patient logins, from a Shared Access-Portal Activity Metric, which captured logins using shared access credentials. Finally, average length of portal sessions (in minutes) was computed for each patient and shared access portal account based on date/time-stamped login and logout interactions, or, in cases in which there was no logout and the session instead timed out, the time between login and the last user action taken prior to the next login.…”

Section: Methodsmentioning

confidence: 99%

“…A session was defined by the patient or care partner conducting at least one portal activity other than logging in. We constructed a Portal Activity Metric, defined as the ratio of logins (either patient or care partner with “shared access” credentials, in the numerator) to clinical visits incurred by the patient for a specified observation period (in the denominator), as described previously 24 . We differentiated a Patient‐Portal Activity Metric, which captured patient logins, from a Shared Access‐Portal Activity Metric, which captured logins using shared access credentials.…”

Section: Methodsmentioning

confidence: 99%

Use of the patient portal among older adults with diagnosed dementia and their care partners

Gleason

Wec

et al. 2023

Alzheimer's & Dementia

Self Cite

View full text Add to dashboard Cite

INTRODUCTIONCare partners are at the forefront of dementia care, yet little is known about patient portal use in the context of dementia diagnosis.METHODSWe conducted an observational cohort study of date/time‐stamped patient portal use for a 5‐year period (October 3, 2017–October 2, 2022) at an academic health system. The cohort consisted of 3170 patients ages 65+ with diagnosed dementia with 2+ visits within 24 months. Message authorship was determined by manual review of 970 threads involving 3065 messages for 279 patients.RESULTSMost (71.20%) older adults with diagnosed dementia were registered portal users but far fewer (10.41%) had a registered care partner with shared access. Care partners authored most (612/970, 63.09%) message threads, overwhelmingly using patient identity credentials (271/279, 97.13%).DISCUSSIONThe patient portal is used by persons with dementia and their care partners. Organizational efforts that facilitate shared access may benefit the support of persons with dementia and their care partners.HIGHLIGHTS Patient portal registration and use has been increasing among persons with diagnosed dementia. Two thirds of secure messages from portal accounts of patients with diagnosed dementia were identified as being authored by care partners, primarily using patient login credentials. Care partners who accessed the patient portal using their own identity credentials through shared access demonstrate similar levels of activity to patients without dementia. Organizational initiatives should recognize and support the needs of persons with dementia and their care partners by encouraging awareness, registration, and use of proper identity credentials, including shared, or proxy, portal access.

show abstract

Patient Portal Use Among Older Adults With Dementia Diagnosis

Abstract: This cohort study assesses the level of engagement with an electronic health management system among patients with recently diagnosed dementia and their caregivers.

Cited by 6 publications

References 6 publications

Enhanced Patient Portal Engagement Associated with Improved Weight Loss Outcomes in Post-Bariatric Surgery Patients

Enhanced Patient Portal Engagement Associated with Improved Weight Loss Outcomes in Post-Bariatric Surgery Patients

Patient portal interventions: a scoping review of functionality, automation used, and therapeutic elements of patient portal interventions

Use of the patient portal among older adults with diagnosed dementia and their care partners

Contact Info

Product

Resources

About