Implementing and Using a Patient Portal: A qualitative exploration of patient and provider perspectives on engaging patients

Background The use of portals might be expected to rise; however, adoption has been slow. Development of portals has occurred with limited patient involvement. This paper fills a need for literature concerning perspectives regarding the value of portals, how best to organize and provide portals, and critically how to seek patient involvement in implementation.ObjectiveThe objective was to explore the feelings, ideas, and expectations of patients and primary care providers concerning the implementation and use of patient portals.MethodsThe study employed a descriptive qualitative design interviewing seven patients and four providers from an interdisciplinary primary health care clinic in Ontario, Canada. Patients were older with at least one chronic condition. Interviews were analysed independently by three coders who then met to synthesize the findings.ResultsThere was limited experience of portals and substantial convergence between patients and providers regarding concerns and potential benefits with an overall positive view. Four themes emerged: 1) the Context in which patient portal use takes place; 2) the Necessary conditions for use of a patient portal; 3) the Implementation of a patient portal; and 4) the Use of a patient portal for care.ConclusionFindings highlight that it is not sufficient to engage patients in the use of a portal; it is critical that patients be engaged in the early stages of implementation. With many health and fitness electronic tools available (e.g. Fitbit©), this study remind us that tools are not enough. Patient engagement requires patient-centred partnerships between patients and health care providers.

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Participants’ views and experiences from setting up a shared patient portal for primary and specialist health services- a qualitative study

BMC Health Services Research ◽

10.1186/s12913-021-06188-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Torunn Hatlen Nøst ◽

Arild Faxvaag ◽

Aslak Steinsbekk

Keyword(s):

Health Care ◽

Qualitative Study ◽

Health Services ◽

Health Care Providers ◽

Access To Health Care ◽

Patient Involvement ◽

Patient Portal ◽

Care Providers ◽

Structured Interviews ◽

Patient Portals

Abstract Background Recently, there has been an increasing focus among healthcare organisations on implementing patient portals. Previous studies have mainly focussed on the experiences of patient portal use. Few have investigated the processes of deciding what content and features to make available, in particular for shared portals across healthcare domains. The aim of the study was to investigate views on content and experiences from the configuration process among participants involved in setting up a shared patient portal for primary and specialist health services. Methods A qualitative study including 15 semi-structured interviews with persons participating in patient portal configuration was conducted from October 2019 to June 2020. Results Whether a shared patient portal for all the health services in the region should be established was not questioned by any of the informants. It was experienced as a good thing to have numerous participants present in the discussions on configuration, but it also was said to increase the complexity of the work. The informants considered a patient portal to be of great value for patient care, among other things because it would lead to improvements in patient follow-up and increased patient empowerment. Nevertheless, some informants advocated caution as they thought the patient portal possibly could lead to an increase in healthcare providers’ workloads and to anxiety and worries, as well as to inequality in access to health care among patients. The findings were categorized into the themes ‘A tool for increased patient involvement’, ‘Which information should be available for the patient’, ‘Concerns about increased workload’, ‘Too complex to use versus not interesting enough’, ‘Involving all services’ and ‘Patient involvement’. Conclusions Establishing a shared patient portal for primary and specialist health services was considered unproblematic. There was, however, variation in opinions on which content and features to include. This variation was related to concerns about increasing the workload for health care providers, causing anxiety and inequality among patients, and ensuring that the solution would be interesting enough to adopt.

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SAT0640-HPR RHEUMATOLOGY CARE OF MIGRANTS FROM SUB-SAHARAN AFRICA; A QUALITATIVE PILOT STUDY OF PATIENTS’ PERSPECTIVES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2789 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1279.1-1279

Author(s):

Z. Rutter-Locher ◽

J. Galloway ◽

H. Lempp

Keyword(s):

Rheumatoid Arthritis ◽

Health Care ◽

Health Care Providers ◽

Unmet Need ◽

Primary Care Providers ◽

Sub Saharan Africa ◽

Care Providers ◽

Specialist Care ◽

Sub Saharan ◽

The Uk

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared

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A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

Frontiers in Public Health ◽

10.3389/fpubh.2021.762784 ◽

2021 ◽

Vol 9 ◽

Author(s):

Alicia K. Matthews ◽

Karriem S. Watson ◽

Cherdsak Duang ◽

Alana Steffen ◽

Robert Winn

Keyword(s):

Health Care ◽

Smoking Cessation ◽

Health Care Providers ◽

Low Income ◽

Access To Health Care ◽

Social Determinant ◽

Evidence Based ◽

Patient Portal ◽

Care Providers ◽

Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

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Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.155 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 155-155

Author(s):

Cleo A. Samuel ◽

Kea Turner ◽

Heidi AS Donovan ◽

G J. Van Londen

Keyword(s):

Health Care ◽

Endocrine Therapy ◽

Health Care Providers ◽

Symptom Management ◽

Adjuvant Endocrine Therapy ◽

Barriers And Facilitators ◽

System Level ◽

Care Providers ◽

Provider Perspectives ◽

Related Symptom

155 Background: Adjuvant endocrine therapy (AET)-related symptom management (SM) among breast cancer survivors (BCS) typically involves a multidisciplinary team of health care providers; yet few studies have examined provider perspectives on AET-related SM. The purpose of this study was to examine provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. Methods: We conducted 3 focus groups (FGs) with a multidisciplinary group of health care providers (n = [6] physician; n = [7] non-physician) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM and its barriers and facilitators as well as recommendations for improvement. All FGs were held at the University of Pittsburgh, audiotaped, and transcribed. We analyzed FG transcripts using qualitative software to identify key themes. Results: Providers described patient-, provider-, and system- level facilitators and barriers to AET-related SM. At the patient-level, facilitators included social support and provider communication about symptoms while cancer-related distress, misinformation and misinterpretation of online information were identified as barriers. Provider-level facilitators included strong relationships with other providers and ongoing communication with patients; however, lack of time, insufficient resources, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Finally, at the system-level, electronic health records were described as both a facilitator and barrier to SM. Moreover, poor care coordination among different providers and lack of clear guidelines on which provider “owns” AET-related SM emerged as key system-level barriers. Conclusions: Findings suggest that efforts to improve AET-related SM should span multiple levels, in order to address patient-, provider-, and system-level barriers to SM. Recommendations include increased education for patients, greater access to clinical decision support tools for providers, and improved coordination of survivorship resources within hospitals.

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Patient and Health Care Provider Perspectives on Long Acting Injectable Antipsychotics in Schizophrenia and the Introduction of Olanzapine Long-Acting Injection

Journal of Central Nervous System Disease ◽

10.4137/jcnsd.s4091 ◽

2011 ◽

Vol 3 ◽

pp. JCNSD.S4091 ◽

Cited By ~ 3

Author(s):

Heidi J. Wehring ◽

Sheryl Thedford ◽

Maju Koola ◽

Deanna L. Kelly

Keyword(s):

Health Care ◽

Health Care Provider ◽

Health Care Providers ◽

Care Provider ◽

Treatment Options ◽

Care Providers ◽

Provider Attitudes ◽

Provider Perspectives ◽

Long Acting ◽

Acting Agent

Olanzapine long acting injection has joined risperidone and paliperidone as the second generation long acting antipsychotic injection options for treatment of patients with schizophrenia. Long acting injections are important alternatives to oral medications for patients who have difficulty adhering to daily or multiple daily medication administrations, yet may be underutilized or not well understood. Patient perceptions, adherence, and preferences are important issues for health care providers to address when discussing treatment options with their patients. Reviewed here are overall patient and health care provider attitudes and perceptions regarding long acting injections and the details of olanzapine long acting injectable, the newest agent, and how it will fit in the marketplace. In addition, efficacy, safety, dosing and use data regarding this newest long acting agent are reviewed and compared to other available long acting agents.

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Viewpoint: Health literacy and patient portals

Journal of Primary Health Care ◽

10.1071/hc15172 ◽

2015 ◽

Vol 7 (2) ◽

pp. 172 ◽

Cited By ~ 5

Author(s):

Yulong Gu ◽

Martin Orr ◽

Jim Warren

Keyword(s):

Health Care ◽

Health Literacy ◽

Health Information ◽

Health Care Providers ◽

Easy Access ◽

Patient Portal ◽

Care Providers ◽

Patient Portals ◽

Health Consumer ◽

Improve Patient

Health literacy has been described as the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Improving health literacy may serve to promote concordance with therapy, engage patients in their own health care, and improve health outcomes. Patient portal technology aims at enabling patients and families to have easy access to key information in their own medical records and to communicate with their health care providers electronically. However, there is a gap in our understanding of how portals will improve patient outcome. The authors believe patient portal technology presents an opportunity to improve patient concordance with prescribed therapy, if adequate support is provided to equip patients (and family/carers) with the knowledge needed to utilise the health information available via the portals. Research is needed to understand what a health consumer will use patient portals for and how to support a user to realise the technology?s potential.

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Emotional Responses And Perceived Stressors Of Frontline Medical Staffs In Case Of Addis Ababa Covid-19 Treatment Centers And Obstetrics Emergency And Abortion Care Clinic, Ethiopia; Analytical Cross Sectional Study

10.21203/rs.3.rs-107059/v1 ◽

2020 ◽

Author(s):

Mebratu Kebede ◽

Dereje Demissie ◽

Dessalegn Guddu ◽

Michael Haile ◽

Zebenay Bitew ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Providers ◽

Emotional Response ◽

Addis Ababa ◽

Emotional Responses ◽

Care Providers ◽

Front Line ◽

Care Clinic ◽

Abortion Care

Abstract Background: the rapid spread of COVID-19, its lethality in severe cases and the absence of specific medicine poses a huge threat to human life and health, as well as huge impact on the mental health. Facing this critical situation, health care workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms including emotional disturbance.Objective: the aim of this study will be to assess the current state of emotional responses and perceived stressors of frontline medical staffs in case of Addis Ababa COVID-19 Treatment Centers and obstetrics emergency and abortion care, Ethiopia 2020Methods: Hospital based comparative cross-section study design was conducted by using self-administered questionnaire survey from June 1st to 30th of 2020 among 133 and 266 frontline medical staffs from obstetric emergency and abortion care clinic and COVID-19 treatment centers respectively. The data were collected after getting written consent from each participant and it entered into the computer using Epi-data version 7, then exported to SPSS version 20 for further analysis. Descriptive analysis was done using frequencies & percent. All independent determinants with P-value <0.05 were used to identify important predictors of emotional responses and perceived stressors. Result; A total of 399 frontline medical staffs were included in the study. The mean age of the respondents of those who were working in obstetrics emergency and abortion care clinic was 27.47 (SD=3.46) years and it was 28.12 (SD=4.09) years for the other groups. This study revealed that, 72.9% and 5.6% of the study participant from obstetrics emergency and abortion clinic and COVID-19 treatment centers had a positive emotional response, respectively. Factors such as having a low level of motivational factors (AOR 2.78, 95% CI (1.13, 6.84)), being a nurse (AOR 10.53, 95% CI (1.31, 85.26)) and working at triage (AOR 8.61, 95% CI (1.15, 64.81))) had statistically significant association with negative emotional response.Conclusion; The current study revealed that a high proportion of front line a negative emotional responses had negative emotional response. Further, almost all of the medical staffs working in COVID-19 treatment centers and at obstetrics emergency and abortion care unit had perceived the outbreak related stressors. So, providing comprehensive psychological support is warranted for health care providers working in such kinds of department or units.

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Identification of Frailty in Primary Care: Feasibility and Acceptability of Recommended Case Finding Tools Within a Primary Care Integrated Seniors’ Program

Gerontology and Geriatric Medicine ◽

10.1177/2333721419848153 ◽

2019 ◽

Vol 5 ◽

pp. 233372141984815 ◽

Cited By ~ 5

Author(s):

Marjan Abbasi ◽

Sheny Khera ◽

Julia Dabravolskaj ◽

Melanie Garrison ◽

Sharla King

Keyword(s):

Primary Care ◽

Health Care ◽

Focus Groups ◽

Health Care Providers ◽

Case Finding ◽

Community Dwelling ◽

Completion Rate ◽

Walk Test ◽

Care Providers ◽

Care Clinic

Background: Case finding for frailty is recommended as part of routine clinical practice. We aimed to test feasibility and acceptability of three recommended case finding tools in primary care as part of an integrated seniors’ program. Method: Program of Research to Integrate Services for the Maintenance of Autonomy-7 (PRISMA-7), 4-m walk test, and electronic frailty index (eFI) were used as frailty case finding tools for a target population of community-dwelling seniors ≥65 years of age enrolled in a seniors’ program within an academic primary care clinic in Alberta, Canada. Feasibility was measured by percent completion rate and requirements for training/equipment/space/time, and acceptability by health care providers was measured using focus groups. Results: Eighty-five patients underwent case finding and 16 health care providers participated in the focus groups. Completion rate for PRISMA-7, 4-m walk test, and eFI was 97.6%, 93%, and 100%, respectively. No special training or equipment was required for PRISMA-7; brief training, equipment, and space were required for 4-m walk test. Both tools took less than 5 min to complete. Despite eFI requiring 10 to 20 min/patient chart, providers found it less intrusive. Conclusion: Despite feasibility of the tests, acceptance was higher for tools with minimal clinic interruption, low requirements for resources, and those with added benefit.

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Exploring Interpersonal Relationships in a Nurse-Managed Clinic and Their Impact on Clinical Outcomes

SAGE Open ◽

10.1177/2158244019858436 ◽

2019 ◽

Vol 9 (3) ◽

pp. 215824401985843

Author(s):

Charlotte T. Lee ◽

Susanne Phillips ◽

Susan Tiso ◽

Camille Fitzpatrick

Keyword(s):

Health Care ◽

Interpersonal Relationships ◽

Health Care Providers ◽

Access To Health Care ◽

Primary Care Clinic ◽

Patient Characteristics ◽

Care Providers ◽

Care Clinic ◽

Outcomes Of Care ◽

The Impact

This study explores the impact of interpersonal relationships on processes and outcomes of care at a nurse-managed, primary care clinic in Southern California serving a vulnerable population. Ten semistructured interviews were conducted with all health care providers in the clinic to explore patient characteristics, types of relationships experienced, and how they may have affected processes and outcomes of care. Themes in interviews were identified through thematic analysis. We found that (a) patients with limited access to health care and resources establish different types of relationships to support their needs, and (b) interpersonal relationships, including those among providers, affect quality of care.

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