The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review

Carini, E; Villani, Leonardo; Pezzullo, Angelo Maria; Gentili, Andrea; Barbará, Andréa; Ricciardi, Walter; Boccia, Stefania

doi:10.2196/26189

Cited by 67 publications

(39 citation statements)

References 63 publications

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“…The impact of SDM aids delivered via EHRs has previously been shown to be feasible and acceptable to users for the management of long-term conditions in a primary care context. 58 Use of EHR-linked patient portals has also been associated with observed improvements in health status monitoring, patient–doctor interactions, overall care quality, and patient satisfaction around decision making; 59 – 61 however, utilisation with these digital approaches in these studies may have been more closely associated with increased patient age profiles and with female sex.…”

Section: Discussionmentioning

confidence: 97%

Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study

et al. 2021

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BackgroundThe important role of primary care in promoting healthy lifestyle behaviours needs informed support.AimTo elicit views on a 39-item shared decision-making (SDM) aid (SHARE-D) for lifestyle change and refine it to improve implementation.Design & settingMixed methods study.MethodHealth professionals, patients, and support workers, with experience of managing, or a history of, cardio- or cerebrovascular disease, were purposively recruited based on age, gender, and urban/rural location (n = 34). Participants completed a survey, rating the importance of including each item in a decision-aid, designed for use by patients with health professionals, and suggesting modifications. Semi-structured interviews (n = 30/34) were conducted and analysed thematically.ResultsSubstantial agreement was observed on rating item inclusion. Based on survey and interview data, 9/39 items were removed; 13 were amended. Qualitative themes were: (i) core content of the decision-aid, (ii) barriers to use, (iii) motivation for lifestyle change, and (iv) primary care implementation. ‘Self-reflective’ questions and goal setting were viewed as essential components. The paper-based format, length, clarity, and time required were barriers to its use. Optional support considered within the aid was seen as important to motivate change. A digital version, integrated into patient record systems was regarded as critical to implementation. A revised 30-item aid was considered suitable for facilitating brief conversations and promoting patient autonomy.ConclusionThe SHARE-D decision aid for healthy lifestyle change appears to have good content validity and acceptability. Survey and interview data provided in-depth information to support implementation of a refined version. Further studies should examine its effectiveness.

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Section: Discussionmentioning

confidence: 97%

Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study

et al. 2021

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“…GPs considered digital health to be the future, offering a good solution for organizing care more efficiently and positively influencing the doctor-patient relationship, as suggested elsewhere [ 41 ]. However, some patients considered the platform impersonal and were neutral about its impact on their relationship with the doctor.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Digital Self-management Platform for Patients With Chronic Illness in Primary Care: Qualitative Study of Stakeholders’ Perspectives

Vijver¹,

Hummel²,

Dijk³

et al. 2022

JMIR Form Res

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Background Population aging and multimorbidity has led to increasing chronic care needs associated with new challenges in managing growing costs, rising health care professional workloads, and the adoption of rigorous guidelines. These issues could all benefit from greater digitalization and a more patient-centered approach to chronic care, a situation brought to the fore by the COVID-19 pandemic. Little is known about real-life use in primary care. Objective This study aimed to explore the views, thoughts, usability, and experiences concerning a recently introduced digital self-care platform for chronic conditions in 3 Dutch primary care practices. Methods We conducted an explorative study combining questionnaires and interviews among patients and general practitioners from 3 general practices that used the digital platform. Questionnaires were sent to patients in each practice to seek the views and experiences of both patient nonusers (n=20) and patient users (n=58) of the platform, together with standardized questionnaires about illness perception and quality of life. In addition, patients (n=15) and general practitioners (n=4) who used the platform took part in semistructured interviews. We transcribed interviews verbatim and performed qualitative content analysis using a deductive approach. The results of the questionnaires were analyzed with descriptive analysis. Results Among patients who had not actively used the platform but had received an explanation, only 35% (7/20) would recommend its use due to concerns over communication and handling. However, this percentage increased to 76.3% (45/59) among the people who actively used the platform. Interviews with patients and general practitioners who used the platform uncovered several key benefits, including reduced time requirements, reduced workload, improved care quality, and improved accessibility due to the greater patient-centeredness and use of different communication tools. In addition, the self-management tool led to greater patient autonomy and empowerment. Although users considered the platform feasible, usable, and easy to use, some technical issues remained and some patients expressed concerns about the reduction in human contact and feedback. Conclusions The overall experience and usability of the platform was good. Support for the online self-management platform for chronic care increased when patients actively used the tool and could experience or identify important advantages. However, patients still noted several areas for improvement that need to be tackled in future iterations. To ensure benefit in the wider population, we must also evaluate this platform in cohorts with lower digital and health literacy.

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“…Patient portals are secure locations on the internet from which patients can access personal health information, schedule appointments, communicate with their providers, and connect with providers for video-based appointments [ 14 - 16 ]. In behavioral health settings, patient portals have been shown to increase a sense of patient autonomy, improve patient activation, and decrease administrative inefficiencies [ 17 , 18 ]. A recent study in a large health system across multiple specialties has also demonstrated patient portal activation is associated with increased patient ability to complete telemedicine visits [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Patient Preferences for Patient Portal–Based Telepsychiatry in a Safety Net Hospital Setting During COVID-19: Cross-sectional Study

Yue¹,

Mail²,

DiSalvo³

et al. 2022

JMIR Form Res

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Background Patient portals are a safe and secure way for patients to connect with providers for video-based telepsychiatry and help to overcome the financial and logistical barriers associated with face-to-face mental health care. Due to the COVID-19 pandemic, telepsychiatry has become increasingly important to obtaining mental health care. However, financial and technological barriers, termed the “digital divide,” prevent some patients from accessing the technology needed to use telepsychiatry services. Objective As an extension to a clinic’s outreach project during COVID-19 to improve patient engagement with video-based visits through the hospital’s patient portal among adult behavioral health patients at an urban safety net hospital, we aim to assess patient preference for patient portal–based video visits or telephone-only visits and to identify the demographic variables associated with their preference. Methods Patients in an outpatient psychiatry clinic were contacted by phone, and preference for telepsychiatry by phone or video through a patient portal, as well as device preference for video-based visits, were documented. Patient demographic characteristics were collected from the electronic medical record. Results A total of 128 patients were reached by phone. A total of 79 (61.7%) patients chose video-based visits, and 69.6% (n=55) of these patients preferred to access the patient portal through a smartphone. Older patients were significantly less likely to agree to video-based visits. Conclusions Among behavioral health patients at a safety net hospital, there was relatively low engagement with video-based visits through the hospital’s patient portal, particularly among older adults.

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The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review

Cited by 67 publications

References 63 publications

Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study

Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study

Evaluation of a Digital Self-management Platform for Patients With Chronic Illness in Primary Care: Qualitative Study of Stakeholders’ Perspectives

Patient Preferences for Patient Portal–Based Telepsychiatry in a Safety Net Hospital Setting During COVID-19: Cross-sectional Study

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