scholarly journals Older Adults' Perceptions and Use of Patient Portals: A Comparative Analysis of Two Samples

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 837-837
Author(s):  
Hyojin Son ◽  
Eun-Shim Nahm ◽  
Shijun Zhu ◽  
Elizabeth Galik ◽  
Barbara Van de Castle ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older Adult ◽  
Health Care System ◽  
Self Efficacy ◽  
Community Sample ◽  
Patient Portal ◽  
Patient Portals ◽  
Perceived Usability ◽  
Care System

Abstract Older adults can benefit from using patient portals. Little is known whether the perceptions and use of patient portals differ among diverse older adult populations. The aim of this study was to assess the difference in perceived usability of patient portals, self-efficacy for using patient portals, and patient portal use between two adult samples aged 65 years or older. One sample was recruited from a health care system, including hospitals and clinics (n = 174), and the other sample was recruited from nationwide communities (n = 126). Conducting a secondary data analysis using two survey datasets, this study performed a series of linear and ordinal logistic regression analyses. The health care system sample had a higher mean number of chronic diseases and proportion of recent hospitalization than the community sample. The health care system sample showed higher perceived usability, self-efficacy, and usage frequency of patient portals compared to the community sample. eHealth literacy was a significant predictor of perceived usability and self-efficacy. Perceived usability was another significant predictor of self-efficacy. Self-efficacy and health condition variables significantly predicted the more frequent use of patient portals. Compared to the health care system sample, the relationship between perceived usability and use of patient portals was stronger and significant in the community sample. These findings suggest that approaches for promoting patient portal use should consider personal characteristics and health conditions of diverse older adult populations. Future research needs to focus on assessing the impact of using patient portals on older adults’ health care outcomes.

scholarly journals Patient portals and broadband internet inequality

2017 ◽  
Vol 24 (5) ◽  
pp. 927-932 ◽  
Author(s):  
Adam T Perzynski ◽  
Mary Joan Roach ◽  
Sarah Shick ◽  
Bill Callahan ◽  
Douglas Gunzler ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Quality ◽  
Internet Access ◽  
Care Quality ◽  
Public Health Care ◽  
Patient Portal ◽  
Patient Portals ◽  
Broadband Internet ◽  
Care System

Abstract Background: Patient portals have shown potential for increasing health care quality and efficiency. Internet access and other factors influencing patient portal use could worsen health disparities. Methods: Observational study of adults with 1 or more visits to the outpatient clinics of an urban public health care system from 2012 to 2015. We used mixed effects logistic regression to evaluate the association between broadband internet access and (1) patient portal initiation (whether a patient logged in at least 1 time) and (2) messaging, controlling for demographic and neighborhood characteristics. Results: There were 243 248 adults with 1 or more visits during 2012–2015 and 70 835 (29.1%) initiated portal use. Portal initiation was 34.1% for whites, 23.4% for blacks, and 23.8% for Hispanics, and was lower for Medicaid (26.5%), Medicare (23.4%), and uninsured patients (17.4%) than commercially insured patients (39.3%). In multivariate analysis, both initiation of portal use (odds ratio [OR] = 1.24 per quintile, 95% confidence interval [CI], 1.23–1.24, P < .0001) and sending messages to providers (OR = 1.15, 95%CI, 1.09–1.14, P < .0001) were associated with neighborhood broadband internet access. Conclusions: The majority of adults with outpatient visits to a large urban health care system did not use the patient portal, and initiation of use was lower for racial and ethnic minorities, persons of lower socioeconomic status, and those without neighborhood broadband internet access. These results suggest the emergence of a digital divide in patient portal use. Given the scale of investment in patient portals and other internet-dependent health information technologies, efforts are urgently needed to address this growing inequality.

scholarly journals Patient Portal Use Among Older Adults: What Is Really Happening Nationwide?

2018 ◽  
Vol 39 (4) ◽  
pp. 442-450 ◽  
Author(s):  
Eun-Shim Nahm ◽  
Shijun Zhu ◽  
Michele Bellantoni ◽  
Linda Keldsen ◽  
Kathleen Charters ◽  
...  
Keyword(s):  
Older Adults ◽  
Electronic Health Records ◽  
Older Adult ◽  
Chronic Conditions ◽  
Patient Portal ◽  
Perceived Benefits ◽  
Community Settings ◽  
Patient Portals ◽  
Health Records ◽  
Current State

Patient portals (PPs), secure websites that allow patients to access their electronic health records and other health tools, can benefit older adults managing chronic conditions. However, studies have shown a lack of PP use in older adults. Little is known about the way they use PPs in community settings and specific challenges they encounter. The aim of this study was to examine the current state of PP use in older adults, employing baseline data (quantitative and qualitative) from an ongoing nationwide online trial. The dataset includes 272 older adults (mean age, 70.0 years [50-92]) with chronic conditions. Findings showed that the majority of participants (71.3%) were using one or more PPs, but in limited ways. Their comments revealed practical difficulties with managing PPs, perceived benefits, and suggestions for improvement. Further studies with different older adult groups (e.g., clinic patients) will help develop and disseminate more usable PPs for these individuals.

scholarly journals A Usability and Feasibility Study: GENIE - An App Supporting Self-Management among Older Adults who are High Users of the Health Care System (Preprint)

2020 ◽  
Author(s):  
Ruta Valaitis ◽  
Laura Cleghorn ◽  
Ivaylo Vassilev ◽  
Anne Rogers ◽  
Jenny Ploeg ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Social Networks ◽  
Social Services ◽  
Health Care System ◽  
Self Management ◽  
Health And Social Services ◽  
Primary Care Clinicians ◽  
Care System

BACKGROUND Primary care providers have been tasked with fostering self-management through managing referrals and linking patients to community-based health and social services. This study evaluated a web-based tool –GENIE (Generating Engagement in Network InvolvEment)– as a component of the Health TAPESTRY program to support self-management of older adults who are high health care system users. GENIE aims to empower patients to leverage their personal social networks to access community services towards reaching their health goals. GENIE maps client’s personal networks, elicits preferences, and filters local health and social resources from a community service directory based on results of a questionnaire that explores client’s interests. In the Health TAPESTRY program, volunteers conducted home visits to gather health information on tablets and implemented the GENIE tool. A report was generated for the primary care team for follow up. OBJECTIVE This study examined the usability, feasibility, and perceived outcomes of the implementation of GENIE with older adults who were enrolled in Ontario’s Health Links Program, which coordinates care for the highest users of the health care system. METHODS This study involved two primary care clinician focus groups, one clinician interview, a volunteer focus group, client telephone interviews, field observations, and GENIE utilization statistics. RESULTS Eight patients, three volunteers, and 16 primary care clinicians participated. Patients were most interested in services that were health-related (exercise and socialization). Overall, participants perceived GENIE to be useful and easy to use, despite challenges related to email set up, disease terminology, instructions for personal network mapping, and clarity of questionnaire items. Volunteer facilitation was critical to support implementation of Genie. Tool completion averaged 39 minutes. Almost all patients identified a community program or activity of interest using GENIE. Half followed up on health and social services and added new members to their network over 6 months, while one participant lost a member. Clinicians had concerns about accuracy, suitability, and quantity of suggested programs and services generated from the tool and believed that they could better tailor choices for their patients highlighting the inherent tension between user-centred preferences focused on capabilities and bio-medical definitions of need shaping professional judgement. However, clinicians did note that GENIE strengthened their understanding of patients’ personal social networks. CONCLUSIONS This study demonstrated GENIE’s potential, facilitated by volunteers, to expand patients’ social networks and link them to relevant health and social services to support self-management. Volunteers require training to effectively implement GENIE for self-management support and can help overcome time limitations that primary care clinicians face. Refining the filtering capability of GENIE to allow for better tailoring of results to address the complex needs of those who are high system users may help to improve primary care provider’s confidence in such tools. CLINICALTRIAL Not applicable

scholarly journals Patient and Health Care Provider Experiences With a Recently Introduced Patient Portal in an Academic Hospital in the Netherlands: Mixed Methods Study

10.2196/13743 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e13743 ◽  
Author(s):  
Maria M T Vreugdenhil ◽  
Sander Ranke ◽  
Yvonne de Man ◽  
Maaike M Haan ◽  
Rudolf B Kool
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
The Netherlands ◽  
Health Care System ◽  
Mixed Methods Study ◽  
Patient Portal ◽  
Academic Hospital ◽  
Patient Portals ◽  
Work Processes ◽  
One Year

Background In the Netherlands, the health care system and related information technology landscape are fragmented. Recently, hospitals have started to launch patient portals. It is not clear how these portals are used by patients and their health care providers (HCPs). Objective The objective of this study was to explore the adoption, use, usability, and usefulness of a recently introduced patient portal in an academic hospital to learn lessons for the implementation of patient portals in a fragmented health care system. Methods A mixed methods study design was used. In the quantitative study arm, characteristics of patients who used the portal were analyzed, in addition to the utilization of the different functionalities of the portal. In the qualitative study arms, think-aloud observations were made to explore usability. Focus group discussions were conducted among patients and HCPs of the dermatology and ophthalmology outpatient departments. Thematic content analysis of qualitative data was carried out and overarching themes were identified using a framework analysis. Results One year after the introduction of the portal, 24,514 patients, 13.49% of all patients who visited the hospital, had logged in to the portal. Adoption of the portal was associated with the age group 45 to 75 years, a higher socioeconomic status, and having at least one medical diagnosis. Overarching themes from the qualitative analyses were (1) usability and user-friendliness of the portal, (2) HCP-patient communication through the portal, (3) usefulness of the information that can be accessed through the portal, (4) integration of the portal in care and work processes, and (5) HCP and patient roles and relationships. Conclusions One year after the introduction of the patient portal, patients and HCPs who used the portal recognized the potential of the portal to engage patients in their care processes, facilitate patient-HCP communication, and increase patient convenience. Uncertainties among patients and HCPs about how to use the messaging functionality and limited integration of the portal in care and work processes are likely to have limited portal use and usefulness.

scholarly journals Patient Portal Functionalities and Uptake: Systematic Review Protocol

10.2196/14975 ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. e14975 ◽  
Author(s):  
Abrar Alturkistani ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
Shirin Aliabadi ◽  
Rosemary H Jenkins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care System ◽  
Health Care Quality ◽  
Care Quality ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Patient Portal ◽  
Patient Portals ◽  
Quality Outcomes

Background Patient portals are digital health tools adopted by health care organizations. The portals are generally connected to the electronic health record of the health care organization and offer patients functionalities such as access to the medical record, ability to order repeat prescriptions, make appointments, or message the health care provider. Patient portals may be beneficial for both patients and the health care system. Patient portals can widely differ from one context to another due to the differences in the portal functionalities and capabilities and it is anticipated that outcomes associated with the functionalities also differ. Current systematic reviews report outcomes associated with patient portal uptake but do not explicitly specify the patient portal functionalities. Objective The aim of this systematic review is to synthesize the evidence on health and health care quality outcomes associated with patient portal use among adult (18 years or older) patients. The review research questions are as follows: What kind of health outcomes do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? and What kind of health care quality outcomes, including health care utilization outcomes, do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? Methods The systematic review will be conducted by searching the MEDLINE, EMBASE, and Scopus databases for relevant literature. The review inclusion criteria will be studies about adult patients (18 years or older), studies only about tethered patient portals, and studies with or without a comparator. We will report patient portal–associated health and health care quality outcomes based on the patient portal functionalities. All quantitative primary study types will be included. Risk of bias of included studies will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and the National Heart, Lung, and Blood Institute’s quality assessment tools. Data will be synthesized using narrative synthesis and will be reported according to the patient portal functionalities, country, disease, and health care system model. Results Searches will be conducted in September 2019, and the review is anticipated to be completed by the end of June 2020. Conclusions This systematic review will provide an overview of health and health care quality outcomes associated with patient portal use among adult patients, providing detailed information about the functionalities of the portals and their associations with the outcomes. The review could potentially help patient portal evaluation studies by providing insights into outcomes associated with the different functionalities of patient portals. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141131 International Registered Report Identifier (IRRID) PRR1-10.2196/14975

scholarly journals Older adult gay & bisexual male veterans' perception of access and cultural competence within the health care system

2021 ◽  
Author(s):  
◽  
Nicholas C. Neibergall
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Older Adult ◽  
Health Care System ◽  
Theoretical Framework ◽  
Care Staff ◽  
Male Veterans ◽  
Clinical Relationship ◽  
Care System

Previous research has consistently identified health disparities among minority groups, including members of the LGBTQ community. The role of the health care system itself in creating, sustaining, or confronting these disparities has received only modest attention. This qualitative dissertation study examines the experiences of older adult gay and bisexual cisgender male Veterans and their perception of provider cultural competence and the organizational climate of the systems in which they receive health care. An existing theoretical framework, the Origins of Health Care Disparities Model, was used in the conceptualization of this research. Case study method was used to guide the research process and subsequent data analysis. Eight participants (MdnAge = 73, Range = 65-82) from across the United States were interviewed remotely, and both within-case and crosscase themes were generated. Results showed most participants were hesitant about integrating their sexual orientation to their degrees. Participants emphasized the importance of a strong clinical relationship with providers and offered diverse opinions about the impact of previous homophobic incidents and their military background. They suggested strategies for medical providers to provide more culturally informed health care. Specifically, they expressed hope for greater representation of gay health care staff and increased training for doctors and medical trainees to work with older adult gay patients. They described a desire for decreased focus on their sexual behavior and that providers approach the clinical relationship holistically recognizing gay patients are individuals with unique identities, hobbies, and interests. Data-driven conclusions and recommendations are offered informed by the theoretical framework. Keywords: LGBTQ, Veteran, VA, gay, bisexual, cultural competence, health care, health disparity, aging, older adult, case study, clinical encounter

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