OP140 Adult Patient Access To Electronic Health Records

2019 ◽  
Vol 35 (S1) ◽  
pp. 32-32
Author(s):  
Petra Schnell-Inderst ◽  
Stefanie Neyer ◽  
Alexander Hörbst ◽  
Gerhard Müller ◽  
Uwe Siebert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cochrane Review ◽  
Patient Empowerment ◽  
Significant Risk ◽  
Study Groups ◽  
Composite Score ◽  
Patient Portal ◽  
Patient Portals ◽  
Health Related ◽  
Electronic Health

IntroductionIn order to facilitate patient information, patient involvement, and to support patient-centered care, healthcare organizations are increasingly offering access to patient data that are stored in the institution-specific electronic health record (EHR). Patients can access these data, read, and print them, or download and integrate them into any type of patient-held record. This EHR access is typically web-based and called “patient portal” allowing the independent access via the Internet from everywhere. A patient portal may also offer additional features such as prescription requests, appointment booking, messaging, personal health-related reminders, individual therapeutic recommendations, personal diaries, and social networking with other patients. In a Cochrane review, we assessed the effects of providing access to EHR for adult patients on patient empowerment and health-related outcomes compared to usual care.MethodsAccording to the methods of evidence-based medicine, we developed a protocol for a Cochrane review, which is published in the Cochrane database.ResultsWe identified ten randomized controlled trials (RCTs) including 6,668 randomized participants. Seven RCTs took place in the USA, two in Canada, and one in Japan. Additional functionalities of interventions and disease conditions were heterogeneous. Three studies (n = 601) reported on patient empowerment. The risk differences reported were neither statistically significant nor clinically relevant. Eight studies (n = 2,070) reported on nine different risk factors (blood pressure, blood glucose, poor asthma control, 10-year Framingham risk score, cholesterol, body mass index, composite score of eight variables, intraocular pressure, composite score of three variables). The results were heterogeneous. Mostly there were no statistically significant risk differences between study groups.ConclusionsOverall, there is no evidence for a clear positive effect of patient portals on patient empowerment and health related outcomes (mainly risk factors). However, we identified only a small number of studies. The usage of portals was often low and several studies were older.

Electronic Health Record Patient Portals and the Blockchain Technology

2021 ◽  
pp. 218-227
Author(s):  
Jorge Tavares
Keyword(s):  
Medical Information ◽  
Healthcare Providers ◽  
Appointment Scheduling ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Blockchain Technology ◽  
Electronic Health ◽  
Implementation Of Ehr ◽  
E Mail

The electronic health records (EHR) patient portals are an integrated eHealth technology that combines an EHR system and a patient portal, giving patients access to their medical records, exam results, and services, such as appointment scheduling, notification systems, and e-mail access to their physician. EHR patient portals empower patients to carry out self-management activities and facilitate communication with healthcare providers, enabling the patient and healthcare provider to access the medical information quickly. Worldwide governmental initiatives have aimed to promote the use of EHR patient portals. The implementation of EHR patient portals encompasses several challenges, including security, confidentiality concerns, and interoperability between systems. New technological approaches like blockchain could address these issues and enable a successful worldwide implementation of EHR patient portals.

scholarly journals Mental health care professionals’ appraisal of patients’ use of online access to their electronic health record: a qualitative study. (Preprint)

2021 ◽  
Author(s):  
Antonius Mattheus van Rijt ◽  
Pauline Hulter ◽  
Anne Marie Weggelaar-Jansen ◽  
Kees Ahaus ◽  
Bettine Pluut
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Health Record ◽  
Patient Portal ◽  
Patient Access ◽  
Patient Portals ◽  
Electronic Health

BACKGROUND Patients, in a range of health care sectors, can access their medical health record using a patient portal. In mental health care, the use of patient portals among mental health care professionals (MHCPs) remains low. MHCPs worry that patient access to electronic health records will negatively affect the patient’s wellbeing and their own workload. This study explores the appraisal work carried out by MHCPs shortly after the introduction of online patient access and sheds light on the challenges MHCPs face when trying to make a patient portal work for them, the patient, and their relationship. OBJECTIVE This study aims to provide insights into the appraisal work of MHCPs to assess and understand patient access to their electronic health record (EHR) through a patient portal. METHODS We conducted a qualitative study including ten semi-structured interviews (N=11) and a focus group (N=10). Participants were MHCPs from different professional backgrounds and staff employees (e.g., team leaders, communication advisor). We collected data on their opinions and experiences with the recently implemented patient portal and their attempts to modify work practices. RESULTS Our study provides insights into MHCPs’ appraisal work to assess and understand patient access to the EHR through a patient portal. Four topics emerge from our data analysis: 1) appraising the effect on the patient-professional relationship, 2) appraising the challenge of sharing and registering delicate information, 3) appraising patient vulnerability, and 4) redefining consultation routines and registration practices. CONCLUSIONS MHCPs struggle with the effects of online patient access and are searching for the best ways to modify their registration and consultation practices. Our study suggests various solutions to the challenges faced by MHCPs. To optimize the effects of online patient access to EHRs, MHCPs need to be involved in the process of developing, implementing, and embedding patient portals.

scholarly journals Prediction of Postoperative Infection for Patients Undergoing Gastrointestinal Surgery: Findings from Electronic Health Records

2020 ◽  
Vol 11 (2) ◽  
pp. 36-46
Author(s):  
Kyoko Nakazawa ◽  
Takashi Ishikawa ◽  
Akira Toyama ◽  
Toshifumi Wakai ◽  
Kohei Akazawa
Keyword(s):  
Risk Factors ◽  
Electronic Health Records ◽  
Surgical Procedures ◽  
Postoperative Infection ◽  
Gastrointestinal Surgery ◽  
Significant Risk ◽  
Estimating Equation ◽  
Endoscopic Surgical Procedures ◽  
Health Records ◽  
Electronic Health

Introduction: Postoperative infection is a major cause of morbidity and prolonged hospitalization in patients undergoing gastrointestinal surgery. This observational study aimed to investigate the risk factors associated with postoperative infection and to develop a prediction model for postoperative infections that occur after gastrointestinal surgery. Methods: The study population comprised 1637 patients who underwent gastrointestinal surgery at Niigata University Medical and Dental Hospital between June 2013 and May 2017. Observational data from 1883 surgical procedures were used in the statistical analyses (including 198 patients who underwent several operations). Results: The generalized estimating equation (GEE) was used to detect significant risk factors, including older age, history of smoking, body temperature greater than 38 °C, non-endoscopic surgical procedures, surgery in the thoracic or lower gastrointestinal tract, and use of medical nutritional products during surgery. The sensitivity and specificity of the GEE model were 88.2% and 55.1%, respectively. Conclusion: This study established a predictable GEE model, incorporating the data of patients who were hospitalized several times into a prediction analysis, even though the sensitivity was not sufficiently high. The GEE model, which is considered clinically useful, can be constructed using a variety of variables, including those obtained from electronic health records.

Mobile device access to electronic patient portals in oncology: Potential implications for patient and practice experiences.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 179-179
Author(s):  
Kelvin Ky-Minh Pho ◽  
Rong Lu ◽  
Samantha Gates ◽  
Jennifer Cai ◽  
Donglu Xie ◽  
...  
Keyword(s):  
Mobile Devices ◽  
Mobile Device ◽  
Mobile Application ◽  
Underserved Populations ◽  
Patient Characteristics ◽  
Comprehensive Cancer Center ◽  
Patient Portal ◽  
Patient Portals ◽  
Mobile Access ◽  
Electronic Health

179 Background: Mobile devices provide individuals with rapid and frequent access to electronic patient portals. How patients use this growing and widespread technology to review test results and communicate with providers is not known. Methods: Retrospective study of patients enrolled in the MyChart electronic health portal associated with the EPIC electronic medical record in the Harold C. Simmons Comprehensive Cancer Center. We recorded type of portal access according to year and patient characteristics. Associations between patient characteristics and type of portal access were tested using Mann-Whitney test, Chi-square test, and linear Gaussian regression models. Results: Since the availability of mobile access in 2012, 2,524 patients accessed MyChart from a mobile device at least once, accounting for 291,526 mobile logins. The proportion of patients with mobile MyChart logins increased from 4% in 2012 to 13% in 2017 ( P= 0.004). Among these patients, the proportion of logins from mobile devices increased from 22% to 72% ( P< 0.001). Mobile access occurred more frequently among younger ( P< 0.001), black ( P= 0.002), and Hispanic ( P= 0.004) patients. In 2017, among patients who accessed MyChart from mobile devices at least once, those under age 40 years used the mobile application for over 90% of logins; those over age 60 years used the mobile application for 65% of logins. Black and Hispanic patients who used mobile MyChart access did so for approximately 80% of logins, compared to 70% of logins for non-Hispanic white patients. Before 2012, patients who went on to use mobile access averaged about five more logins per year than did mobile application never-users. While login frequency increased for both groups, the change was far greater for mobile application users. After 2012, total portal login frequency increased approximately 110% among patients who used mobile access, compared to 25% among non-users ( P< 0.001). Conclusions: Mobile access to electronic health portals has increased patient portal use, particularly among traditionally underserved populations. How this widely and immediately available technology impacts patient and practice experiences warrants further study.

scholarly journals Mobile Device Applications for Electronic Patient Portals in Oncology

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Kelvin K. Pho ◽  
Rong Lu ◽  
Samantha Gates ◽  
Jennifer Cai ◽  
Donglu Xie ◽  
...  
Keyword(s):  
Mobile Device ◽  
Mobile Application ◽  
Underserved Populations ◽  
Patient Characteristics ◽  
Comprehensive Cancer Center ◽  
Patient Portal ◽  
Patient Portals ◽  
Mobile Access ◽  
Number Of Patients ◽  
Electronic Health

PURPOSE Mobile devices provide individuals with rapid and frequent access to electronic patient portals. We investigated how oncology patients use this technology to review test results and communicate with providers. PATIENTS AND METHODS We performed a retrospective study of patients enrolled in the MyChart electronic health portal associated with the Epic electronic medical record at the Harold C. Simmons Comprehensive Cancer Center from 2012 to 2017. We recorded type of portal access according to year and patient characteristics. Associations among patient characteristics and types of portal access were tested using Mann-Whitney U test, χ2 test, and linear Gaussian regression models. RESULTS Since the availability of a mobile device application in 2012, 2,524 patients with cancer accessed MyChart from a mobile device at least once, which accounted for 291,526 mobile log-ins. The number of patients with MyChart mobile application log-ins increased from 4% in 2012 to 13% in 2017 ( P = .004). Among these patients, the median proportion of log-ins that occurred through mobile device use increased from 22% to 72% during this time period ( P < .001). Mobile access occurred more frequently among younger ( P < .001), black ( P = .002), and Hispanic ( P = .004) patients. Since 2012, total portal log-in frequency increased approximately 110% among patients who used the mobile application compared with 25% among those who did not use the mobile application ( P < .001). CONCLUSION Mobile access to electronic health portals has increased patient portal use, particularly among traditionally underserved populations. How this widely and immediately available technology affects patient expectations and experiences warrants additional study.

scholarly journals Improving infant sleep safety via electronic health record communication: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ethan A. Canty ◽  
Benjamin N. Fogel ◽  
Erich K. Batra ◽  
Eric W. Schaefer ◽  
Jessica S. Beiler ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Controlled Trial ◽  
Intervention Group ◽  
Health Record ◽  
Patient Portal ◽  
Infant Sleep ◽  
Patient Portals ◽  
Safe Sleep ◽  
Electronic Health ◽  
Sleep Safety

Abstract Background With increased use of telehealth, interventions to improve infant sleep environments have not been explored. This study sought to assess the feasibility and efficacy of using electronic health record patient portals to transmit photographs of infant sleep between mothers and healthcare professionals as part of an intervention to promote sleep environments consistent with AAP guidelines. Methods One hundred eighty-four mother-newborn dyads consented to participate in a randomized trial requiring patient portal registration within 1 month of delivery. We first assessed feasibility as measured by a) the proportion of consented mothers enrolling in the portal and b) maternal adherence to prompts to submit photographs of their infant sleeping to the research team through the patient portal. Intervention group mothers were prompted at 1 and 2 months; controls were prompted only at 2 months. Efficacy was determined via research assistant review of submitted photographs. These assistants were trained to detect sudden unexplained infant death risk factors utilizing AAP guidelines. Standardized feedback was returned to mothers through the patient portal. We used Fisher’s Exact test to assess group differences in guideline adherence at 2 months. Results One hundred nine mothers (59%) enrolled in the patient portal and were randomized to intervention (N = 55) and control (N = 54) groups. 21 (38, 95% CI 25–52%) intervention group participants sent photographs at 1 month and received personalized feedback. Across both groups at 2 months, 40 (37, 95% CI 28–46%) sent photographs; 56% of intervention group participants who submitted photographs met all safe sleep criteria compared with 46% of controls (difference 0.10, 95% CI − 0.26 to 0.46, p = .75). Common reasons for guideline non-adherence were sleeping in a room without a caregiver (43%), loose bedding (15%) and objects (8%) on the sleep surface. Conclusions Utilizing the patient portal to individualize safe infant sleep is possible, however, we encountered numerous barriers in this trial to assess its effects on promoting safe infant sleep. Photographs of infants sleeping showed substantial non-adherence to AAP guidelines, suggesting further needs for improvement to promote safe infant sleep practices. Trial registration Name: Improving Infant Sleep Safety With the Electronic Health Record; Clinicaltrials.gov: NCT03662048; Date of Registration: September 7, 2018; Data Sharing Statement: None

scholarly journals Analysis of risk factors for developing complications while treating pulpitis

2014 ◽  
Vol 95 (2) ◽  
pp. 231-235
Author(s):  
T V Aksenova ◽  
A N Bondarenko
Keyword(s):  
Risk Factors ◽  
Treatment Effectiveness ◽  
Significant Risk ◽  
Low Frequency ◽  
Study Groups ◽  
Rehabilitation Program ◽  
Recovery Potential ◽  
Periodontal Infection ◽  
Complications Rate ◽  
The Impact

Aim. To study the influence of different risk factors on complications rate while treating pulpitis. Methods. Retrospective analysis of 130 patients with pulpitis outpatient’s cards, who were treated by vital and devitalized pulp extirpation without additional rehabilitation (63 patients) and with addition of individually selected rehabilitation program (67 patients), was carried out. The presence and rate of risk factors for complications in both study groups were analyzed, the level of their impact in complications formation was assessed. The data were processed by analysis of variance. Results. The most significant risk factors for developing complications while treating pulpitis were low local dental and general recovery potential, multiple foci of dental and periodontal infection, mastication muscles malfunction, malocclusion, mental disorders. 60% of patients had the combination of 3 and more risk factors, which in half of all cases were associated with developing complications, if endodontic treatment of pulpitis was not associated with individually selected rehabilitation. Rehabilitation included physiotherapy (if indicated), e.g. low-frequency alternating magnetic field, intra-channel iodine electrophoresis, individually selected homeopathic drugs, Bach flower essences and kinesiotherapy in addition to full mouth debridement. Conclusion. The impact of a range of risk factors, which can be revealed in conditions of common outpatient dental practice, on pulpitis treatment effectiveness was revealed. The addition of individually selected rehabilitation program, targeted on revealed risk factors elimination, to traditional pulpitis treatment decreases the complications rate.

Accessing Patient Electronic Health Record Portals Safely Using Social Credentials: Case Study (Preprint)

2021 ◽  
Author(s):  
Spencer SooHoo ◽  
Michelle Keller ◽  
Harold Moyse ◽  
Benjamin Robbins ◽  
Matthew McLaughlin ◽  
...  
Keyword(s):  
Social Identity ◽  
Medical Center ◽  
Patient Portal ◽  
Patient Records ◽  
Patient Portals ◽  
Single Sign On ◽  
Single File ◽  
Electronic Health ◽  
The One ◽  
Federated Identity

BACKGROUND Patient portals for electronic health records are becoming increasingly prevalent and important, allowing users to communicate with clinicians, access labs and test results, schedule vaccination appointments, and track health conditions. Their use requires another set of logins and passwords, which can become increasingly unwieldy as patients have records at multiple institutions. Social credentials (e.g. Google, Facebook) are often used in the private sector to allow users to log into websites and can reduce password burden. OBJECTIVE The objective of the Single-FILE (Single Federated Identity Login for EHR) project was to test the feasibility and acceptability of implementing social credentials into a portal for patients with records at two institutions, Cedars-Sinai Medical Center (CSMC) and the California Rehabilitation Institute (CalRehab). METHODS We provided a portal that allowed patients to use a federated identity to access to multiple EHR patient portals with a single sign-on. The federated identity could be either a social identity (Google or Facebook) or one created and managed within Single-FILE. Binding the federated identity to the patient’s EHR identities was performed by confirming the patient had a valid EHR portal login and sending a one-time passcode to a telephone (SMS text or voice) that was stored in the EHR. This step reduced the risk that the binding was being performed with stolen EHR portal credentials since the one-time passcode was being sent a device that was already registered in the EHR. After the binding, the patient could use their federated identity to access their EHR portals at both CSMC and CalRehab. To evaluate the feasibility and acceptability, we recruited patients and/or their caregivers from CalRehab who were (1) 18 years and older, (2) had patient records at both CSMC and CalRehab. Next, we signed up patients onto the Single-FILE portal and connected their patient records. A short qualitative interview was conducted to assess interest and use of the patient portal. Thirty days after sign-up, we called the patients and reviewed use logs to measure use of the Single-FILE portal. RESULTS We enrolled 8 patients and/or their caregivers (spouses or siblings) into the study. Eight patients and/or their caregivers were interviewed at CalRehab, Patients enrolled were predominantly White (88%) and non-Hispanic (62%). Patients noted that they appreciated only having to remember one login as part of Single-FILE and being able to sign up through Facebook. However, we did not see use of Single-FILE by patients after they signed up. CONCLUSIONS The implementation of Single-FILE demonstrated that it is possible to safely bind a social identity to an EHR identity. The use of the one-time passcode sent to the patient’s EHR phone number provides a high degree of confidence that the binding is valid. However, we did not see use by patients of the Single-FILE portal after signup. We hypothesize that patients typically use the patient portal when they receive an email/text from the site that an appointment is upcoming, lab results are available, etc., which then takes them directly to the portal and not to Single-FILE. In other words, use of the patient portal is typically reactive rather than proactive, which limited the use of Single-FILE. Despite this limitation, we found that Single-FILE demonstrated a patient can use an identity they are comfortable with (i.e. social identity and associated credentials) to safely ease the friction associated with access to EHR data.

Use of Patient Portals of Electronic Health Records Remains Low From 2014 to 2018: Results From a National Survey and Policy Implications

2020 ◽  
Vol 34 (6) ◽  
pp. 677-680 ◽  
Author(s):  
Y. Alicia Hong ◽  
Shaohai Jiang ◽  
Piper Liping Liu
Keyword(s):  
Low Socioeconomic Status ◽  
High Speed ◽  
Prior Experience ◽  
Internet Access ◽  
Policy Implications ◽  
White Female ◽  
Patient Portal ◽  
Patient Portals ◽  
Data Safety ◽  
Electronic Health

Purpose: To investigate the trend of patient portal use in the general population and the barriers to adoption. Participants: We analyzed 3 iterations of the Health Information National Trends Survey (HINTS) collected in 2014, 2017, and 2018. Measures: Patient portal use, high-speed Internet access, data safety confidence, prior experience of online patient provider communication (OPPC), and demographic variables. Analysis: Logistic regression analyses were conducted separately for the 3 iterations of HINTS. Results: The use of patient portals increased from 25.6% in 2014 to 30.5% in 2017, and 31.4% in 2018. These users were more likely to be white female with higher levels of education or income. Meanwhile, high-speed Internet access, prior experience of OPPC, and data safety confidence were positive predictors of patient portal use in all 3 iterations. Conclusion: The use of patient portals in the general public remains low and a significant digital divide persists, presenting a major challenge on meaningful use of electronic health record. We call for more effective interventions to address these gaps. Such interventions should target people of low socioeconomic status and focus on improving eHealth literacy and patients’ confidence in data safety.

scholarly journals Analysis of Employee Patient Portal Use and Electronic Health Record Access at an Academic Medical Center

2020 ◽  
Vol 11 (03) ◽  
pp. 433-441 ◽  
Author(s):  
Lina Sulieman ◽  
Bryan Steitz ◽  
S. Trent Rosenbloom
Keyword(s):  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Data ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Clinical Notes ◽  
Usage Patterns ◽  
Electronic Health

Abstract Background Patient portals provide patients and their caregivers online access to limited health results. Health care employees with electronic health record (EHR) access may be able to view their health information not available in the patient portal by looking in the EHR. Objective In this study, we examine how employees use the patient portal when they also have access to the tethered EHR. Methods We obtained patient portal and EHR usage logs corresponding to all employees who viewed their health data at our institution between January 1, 2013 and November 1, 2017. We formed three cohorts based on the systems that employees used to view their health data: employees who used the patient portal only, employees who viewed health data in the EHR only, and employees who used both systems. We compared system accesses and usage patterns for each employee cohort. Results During the study period, 35,172 employees accessed the EHR as part of patients' treatment and 28,631 employees accessed their health data: 25,193 of them used the patient portal and 13,318 accessed their clinical data in EHR. All employees who accessed their records in the EHR viewed their clinical notes at least once. Among EHR accesses, clinical note accesses comprised more than 42% of all EHR accesses. Provider messaging and appointment scheduling were the most commonly used functions in the patient portal. Employees who had access to their health data in both systems were more likely to engage with providers through portal messages. Conclusion Employees at a large medical center accessed clinical notes in the EHR to obtain information about their health. Employees also viewed other health data not readily available in the patient portal.

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