Utilization of EHR to Improve Support Person Engagement in Health Care for Patients With Chronic Conditions

Hodgson, Jennifer L.; Welch, Melissa; Tucker, Emily; Forbes, Thompson H.; Pye, Joseph

doi:10.1177/23743735221077528

Cited by 3 publications

(17 citation statements)

References 42 publications

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“…The ability to access patient health information was consistently identified as facilitating care partner portal use (8 of 12 articles), 22 , 26 , 42 , 44 , 45 , 59 , 60 , 61 with the remaining 4 articles 49 , 50 , 52 , 62 emphasizing importance without specifying directionality and identifying care coordination (eg, messaging, appointment scheduling, and filling prescriptions) as facilitating care partner portal use (8 articles). 30 , 40 , 42 , 45 , 50 , 52 , 59 , 61 …”

Section: Resultsmentioning

confidence: 99%

“…Seven articles 20 , 44 , 57 , 58 , 59 , 62 , 63 reported on health care system processes for proxy access review, although little insight could be gleaned regarding specific practices. In 1 article, 44 patients voiced that both giving and removing care partner access made them feel in control of health information sharing.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen articles, 21 , 25 , 41 , 42 , 44 , 45 , 52 , 59 , 61 , 62 , 64 , 65 , 66 primarily qualitative (8 of 13 articles), 41 , 42 , 44 , 45 , 59 , 63 , 64 , 66 reported on consequences of care partner portal use (eTable 4 in Supplement 1 ). Care partner use of the portal was found to contribute insight into patient health and personhood ( 9 of 16 articles).…”

Section: Resultsmentioning

confidence: 99%

“…Care partner use of the portal was found to contribute insight into patient health and personhood ( 9 of 16 articles). 21 , 41 , 42 , 44 , 59 , 61 , 62 , 64 , 65 Care partners were described as an interpreter of health information in the portal, 42 , 64 thereby enhancing patient understanding. 41 Care partner portal access was reported to benefit continuity of care (8 of 16 articles) 21 , 25 , 41 , 44 , 59 , 61 , 65 , 66 by improving recall of the plan of care 61 and understanding reasons for referrals.…”

Section: Resultsmentioning

confidence: 99%

“… 21 , 41 , 42 , 44 , 59 , 61 , 62 , 64 , 65 Care partners were described as an interpreter of health information in the portal, 42 , 64 thereby enhancing patient understanding. 41 Care partner portal access was reported to benefit continuity of care (8 of 16 articles) 21 , 25 , 41 , 44 , 59 , 61 , 65 , 66 by improving recall of the plan of care 61 and understanding reasons for referrals. 65 Seven articles 42 , 44 , 45 , 61 , 64 , 65 , 66 reported that care partner portal use affected activation of health information by, for example, promoting desired health behaviors.…”

Section: Resultsmentioning

confidence: 99%

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Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

et al. 2022

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ImportanceFamily and other unpaid care partners may bridge accessibility challenges in interacting with the patient portal, but the extent and nature of this involvement is not well understood.ObjectiveTo inform an emerging research agenda directed at more purposeful inclusion of care partners within the context of digital health equity by (1) quantifying care partners’ uptake and use of the patient portal in adolescent and adult patients, (2) identifying factors involving care partners’ portal use across domains of the System Engineering Initiative for Patient Safety model, and (3) assessing evidence of perceived or actual outcomes of care partners’ portal use.Evidence ReviewFollowing Arksey and O’Malley’s methodologic framework, a scoping review of manuscripts published February 1 and March 22, 2022, was conducted by hand and a systematic search of PubMed, PsycInfo, Embase, and Web of Science. The search yielded 278 articles; 125 were selected for full-text review and 41 were included.FindingsFew adult patient portal accounts had 1 or more formally registered care partners (&lt;3% in 7 of 7 articles), but care partners commonly used the portal (8 of 13 contributing articles reported &gt;30% use). Care partners less often authored portal messages with their own identity credentials (&lt;3% of portal messages in 3 of 3 articles) than with patient credentials (20%-60% of portal messages in 3 of 5 articles). Facilitators of care partner portal use included markers of patient vulnerability (13 articles), care partner characteristics (15 articles; being female, family, and competent in health system navigation), and task-based factors pertaining to ease of information access and care coordination. Environmental (26 articles) and process factors (19 articles, eg, organizational portal registration procedures, protection of privacy, and functionality) were identified as influential to care partner portal use, but findings were nuanced and precluded reporting on effects. Care partner portal use was identified as contributing to both patient and care partner insight into patient health (9 articles), activation (7 articles), continuity of care (8 articles), and convenience (6 articles).Conclusions and RelevanceIn this scoping review, care partners were found to be infrequently registered for the patient portal and more often engaged in portal use with patient identity credentials. Formally registering care partners for the portal was identified as conferring potential benefits for patients, care partners, and care quality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

et al. 2022

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

Gleason

Wec

et al. 2023

Alzheimer's & Dementia

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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.

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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

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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.

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Utilization of EHR to Improve Support Person Engagement in Health Care for Patients With Chronic Conditions

Cited by 3 publications

References 42 publications

Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

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

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

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