Using a Patient Portal to Expand Warfarin Self-Management

Emerging adults have been raised in the digital age and are therefore prime candidates for using a patient portal to manage chronic conditions. The limited body of research both identifies the underutilization of the patient portal and suggests increased use of the portal for the chronically ill as a tool to alleviate caregiver stress, as well as a potential modality to assist emerging adults to manage their chronic illnesses. This qualitative study was completed to obtain an understanding of emerging adults familiarity with the electronic patient portal and to elicit the perception of the usefulness of the portal to support self-management of type I diabetes. Findings provide a preliminary understanding of how a sampling of emerging adults with type I diabetes uses, perceives the benefits of, and wants to improve technology for diabetes self-management.

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Development of self-management tip sheets for medical oncology and surgical patients electronically reporting symptoms in the home-care recovery setting.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.299 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 299-299

Author(s):

Deborah Schrag ◽

Raymond U. Osarogiagbon ◽

Sandra L. Wong ◽

Hannah Hazard ◽

Jessica J Bian ◽

...

Keyword(s):

Home Care ◽

Health Systems ◽

Symptom Management ◽

Medical Oncology ◽

Medical Center ◽

Care Team ◽

Surgical Patients ◽

Self Management ◽

Patient Portal ◽

Patient Reported

299 Background: Patients receiving cancer treatments, including chemotherapy and surgery, often face immense morbidities. Poor symptom control frequently leads to decreased quality of life and an increased need for acute care services. For patients undergoing chemo, adverse side effects can deter them from receiving life-saving therapies. Similarly, poorly managed postoperative symptoms can delay recovery and timely receipt of adjuvant therapies. Empowering patients to proactively monitor, electronically report, and effectively treat symptoms in the home-care setting is critical to improving clinical outcomes. Methods: Through the NCI’s Moonshot-funded IMPACT consortium, 6 health systems developed a library of 70 open source symptom management tip sheets for medical oncology and surgical patients. The study team went through an iterative process with medical oncologists, surgeons, practice nurses, health educators, and patient advocates. Careful attention was paid to minimize the usage of regional dialects or idioms to ensure scalability and acceptability. The tip sheets achieved passing scores on two validated healthy literacy and readability tools. Results: Tip sheets were accessible to patients participating in the novel eSyM (electronic symptom management) program, a fully EHR-integrated ePRO model.eSyM and the incorporated tips were deployed at four health systems between fall 2019 and spring 2020 (Baptist Cancer Center, West Virginia University, Dartmouth-Hitchcock Medical Center, and Maine Medical Center). Patients enrolled in eSyM had access to the tip sheet library through their patient portal and could view them at any time. In addition, after completing an ePRO questionnaire, patients were given dedicated links to the tips for symptoms they reported. Each developed tip sheet included 4 sections: 1) things you can do on your own, 2) with over-the-counter medications, 3) with the help of your care team, 4) when to call your care team for help. This simplified structure allowed patients to determine how to manage symptoms on their own and when to seek out assistance. Conclusions: Presenting self-management tip sheets in response to patient-reported symptoms through a fully integrated patient portal platform is a novel approach to symptom management. Future efforts will include deploying the library and platform at two additional health institutions and evaluating the adoption, acceptability, and utilization of the tip sheets and their impact on clinical care outcomes.

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Predictors of Online Patient Portal Use among a Diverse Sample of Emerging Adults: A Cross-Sectional Survey (Preprint)

10.2196/preprints.33356 ◽

2021 ◽

Author(s):

Julie A. Wright ◽

Julie E Volkman ◽

Suzanne G Leveille ◽

Daniel J. Amante

Keyword(s):

Health Literacy ◽

Emerging Adults ◽

Patient Engagement ◽

Self Management ◽

Healthcare Team ◽

Patient Portal ◽

Patient Portals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample

BACKGROUND Self-management of health is becoming increasingly more influenced by Health IT as online patient portals become more common. Patient portals allow patients direct access to their health information and opportunities to engage with their healthcare team. Data suggest that e-Health literacy is an important skill for using portals. Emerging adults (EA; ages 18-29), while generally healthy, are regular users of the healthcare system. A good understanding about their use of online patient portals and how their e-Health literacy skills impact their use is lacking. OBJECTIVE To describe patient portal use and explore the predictors of portal use among a diverse sample of EAs. METHODS A convenience sample, cross-sectional survey study was conducted at two universities. Demographics, healthcare visits, e-Health literacy, patient engagement and use of patient portal features (administrative and clinical) were asked. Logistic regression models were used to examine factors associated with portal use. RESULTS Of the 340 EAs (76% female, 65% white, 47% low income), 54% reported having patient portal access. Of those reporting access, 77% used at least 1 portal feature and 23% reported using none. Significant predictors were patient engagement (OR 1.08, 95% CI 1.04-1.13, p=.001;) and total encounters (OR 1.23, 95% CI 1.05-1.44, p=.009;) but not e-Health literacy. Hispanic and Asian EAs were more likely to be frequent users of clinical portal features than white EAs (Hispanic, OR 2.97, 95%CI 1.03-8.52 p=.043; and Asian, OR 4.28, 95%CI 1.08-16.89, p=.038). CONCLUSIONS Surprisingly, e-Health literacy did not predict use of patient portals in this diverse sample of EAs. Moreover, there may be ethnic differences that are important for healthcare systems to consider. Interventions to promote patient portal use, an essential self-management skill, should include strategies to increase patient engagement with patient portals in EA populations. CLINICALTRIAL N/A

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Health professionals’ expectations of a national patient portal for self-management

International Journal of Medical Informatics ◽

10.1016/j.ijmedinf.2018.06.005 ◽

2018 ◽

Vol 117 ◽

pp. 82-87 ◽

Cited By ~ 6

Author(s):

Sari Kujala ◽

Iiris Hörhammer ◽

Johanna Kaipio ◽

Tarja Heponiemi

Keyword(s):

Health Professionals ◽

Self Management ◽

Patient Portal ◽

National Patient

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Using the Computer-based Health Evaluation System (CHES) to support self-management of symptoms and functional health: Evaluation of hematological patients’ usage of a web-based patient portal (Preprint)

10.2196/preprints.26022 ◽

2020 ◽

Author(s):

Jens Lehmann ◽

Petra Buhl ◽

Johannes M Giesinger ◽

Lisa M Wintner ◽

Monika Sztankay ◽

...

Keyword(s):

Evaluation System ◽

Functional Health ◽

Self Management ◽

Health Evaluation ◽

Patient Portal ◽

Structured Interviews ◽

Patient Portals ◽

Web Based ◽

Patient Reported ◽

Hospital Visits

BACKGROUND Patient portals offer the possibility to assess patient-reported outcome measures (PROMs) remotely and first evidence has demonstrated their potential benefits. OBJECTIVE In this study, we evaluated patients’ use of a web-based patient portal where patients can complete PROMs. The portal was developed to supplement routine monitoring at the Department of Internal Medicine V in Innsbruck. METHODS We included patients with cancer who were already participating in the monitoring at the hospital for usage of the patient portal. Patients were introduced to the portal and asked to complete questionnaires prior to their next hospital visits. We used system access logs and three consecutive semi-structured interviews to analyze patients’ usage and evaluation of the portal. RESULTS Between July 2017 and August 2020, we approached N=122 patients for participation in the study, of whom n=102 (83.6%) consented to use the patient portal. Patients were on average 60 (SD 10.4) years old. Of n=71 patients providing data at all study time points, n=26 (36.6%) patients consistently used the portal prior to their hospital visits. During an average session, patients viewed 5.3 different pages and spent 9.4 minutes logged on to the portal. Feedback from interviews was largely positive with no patients reporting difficulties navigating the survey and 50% of patients valuing the self-management tools provided in the portal. CONCLUSIONS Our study demonstrates how a patient portal can complement a routine PROM implementation at the hospital by reducing the burden of administration for the clinical team and offering an additional way for patients to engage with PROMs.

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Acceptability and Feasibility of Patient Portal As A Tool To Promote Adolescent And Young Adult Self-Management Skills Towards Transition Of Care

10.1542/peds.147.3_meetingabstract.3 ◽

2021 ◽

Author(s):

Sophie H. Allende-Richter ◽

Ashley Benitez ◽

Melanie Ramirez ◽

William Rivera ◽

Shanshan Liu ◽

...

Keyword(s):

Young Adult ◽

Adolescent And Young Adult ◽

Self Management ◽

Patient Portal ◽

Transition Of Care ◽

Management Skills

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Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis

JMIR Diabetes ◽

10.2196/32320 ◽

2021 ◽

Vol 6 (4) ◽

pp. e32320

Author(s):

Stephanie A Robinson ◽

Dane Netherton ◽

Mark Zocchi ◽

Carolyn Purington ◽

Arlene S Ash ◽

...

Keyword(s):

Glycemic Control ◽

Diabetes Management ◽

The United States ◽

Diabetes Control ◽

Self Management ◽

Patient Portal ◽

Cross Sectional ◽

Secure Messaging ◽

Patients With Diabetes ◽

Rural Patients

Background Rural patients with diabetes have difficulty accessing care and are at higher risk for poor diabetes management. Sustained use of patient portal features such as secure messaging (SM) can provide accessible support for diabetes self-management. Objective This study explored whether rural patients’ self-management and glycemic control was associated with the use of SM. Methods This secondary, cross-sectional, mixed methods analysis of 448 veterans with diabetes used stratified random sampling to recruit a diverse sample from the United States (rural vs urban and good vs poor glycemic control). Administrative, clinical, survey, and interview data were used to determine patients’ rurality, use of SM, diabetes self-management behaviors, and glycemic control. Moderated mediation analyses assessed these relationships. Results The sample was 51% (n=229) rural and 49% (n=219) urban. Mean participant age was 66.4 years (SD 7.7 years). More frequent SM use was associated with better diabetes self-management (P=.007), which was associated with better glycemic control (P<.001). Among rural patients, SM use was indirectly associated with better glycemic control through improved diabetes self-management (95% CI 0.004-0.927). These effects were not observed among urban veterans with diabetes (95% CI –1.039 to 0.056). Rural patients were significantly more likely than urban patients to have diabetes-related content in their secure messages (P=.01). Conclusions More frequent SM use is associated with engaging in diabetes self-management, which, in turn, is associated with better diabetes control. Among rural patients with diabetes, SM use is indirectly associated with better diabetes control. Frequent patient-team communication through SM about diabetes-related content may help rural patients with diabetes self-management, resulting in better glycemic control.

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P584 A study evaluating clinicians’ attitudes and preferences for a web-based IBD patient portal designed to facilitate self-management

Journal of Crohn s and Colitis ◽

10.1016/s1873-9946(13)60605-4 ◽

2013 ◽

Vol 7 ◽

pp. S244-S245 ◽

Cited By ~ 1

Author(s):

C. Calvert ◽

S. Lal ◽

C. Stansfield ◽

J. McLaughlin ◽

A. Robinson

Keyword(s):

Self Management ◽

Patient Portal ◽

Web Based

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Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis (Preprint)

10.2196/preprints.32320 ◽

2021 ◽

Author(s):

Stephanie A Robinson ◽

Dane Netherton ◽

Mark Zocchi ◽

Carolyn Purington ◽

Arlene S Ash ◽

...

Keyword(s):

Glycemic Control ◽

Diabetes Management ◽

The United States ◽

Diabetes Control ◽

Self Management ◽

Patient Portal ◽

Cross Sectional ◽

Secure Messaging ◽

Patients With Diabetes ◽

Rural Patients

BACKGROUND Rural patients with diabetes have difficulty accessing care and are at higher risk for poor diabetes management. Sustained use of patient portal features such as secure messaging (SM) can provide accessible support for diabetes self-management. OBJECTIVE This study explored whether rural patients’ self-management and glycemic control was associated with the use of SM. METHODS This secondary, cross-sectional, mixed methods analysis of 448 veterans with diabetes used stratified random sampling to recruit a diverse sample from the United States (rural vs urban and good vs poor glycemic control). Administrative, clinical, survey, and interview data were used to determine patients’ rurality, use of SM, diabetes self-management behaviors, and glycemic control. Moderated mediation analyses assessed these relationships. RESULTS The sample was 51% (n=229) rural and 49% (n=219) urban. Mean participant age was 66.4 years (SD 7.7 years). More frequent SM use was associated with better diabetes self-management (P=.007), which was associated with better glycemic control (P<.001). Among rural patients, SM use was indirectly associated with better glycemic control through improved diabetes self-management (95% CI 0.004-0.927). These effects were not observed among urban veterans with diabetes (95% CI –1.039 to 0.056). Rural patients were significantly more likely than urban patients to have diabetes-related content in their secure messages (P=.01). CONCLUSIONS More frequent SM use is associated with engaging in diabetes self-management, which, in turn, is associated with better diabetes control. Among rural patients with diabetes, SM use is indirectly associated with better diabetes control. Frequent patient-team communication through SM about diabetes-related content may help rural patients with diabetes self-management, resulting in better glycemic control.

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