scholarly journals Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

10.2196/18976 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e18976
Author(s):  
Abrar Alturkistani ◽  
Ambar Qavi ◽  
Philip Emeka Anyanwu ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health Care Quality ◽  
Care Quality ◽  
Risk Of Bias ◽  
Patient Portal ◽  
Patient Portals ◽  
Quality Outcomes ◽  
Patients With Diabetes ◽  
Reported Health

Background Patient portal use could help improve the care and health outcomes of patients with diabetes owing to functionalities, such as appointment booking, electronic messaging (e-messaging), and repeat prescription ordering, which enable patient-centered care and improve patient self-management of the disease. Objective This review aimed to summarize the evidence regarding patient portal use (portals that are connected to electronic health care records) or patient portal functionality use (eg, appointment booking and e-messaging) and their reported associations with health and health care quality outcomes among adult patients with diabetes. Methods We searched the MEDLINE, Embase, and Scopus databases and reported the review methodology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent reviewers screened titles and abstracts, and two reviewers assessed the full texts of relevant studies and performed data extraction and quality assessments of the included studies. We used the Cochrane Collaboration Risk of Bias Tool and the National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool to assess the risk of bias of the included studies. Data were summarized through narrative synthesis. Results Twelve studies were included in this review. Five studies reported overall patient portal use and its association with diabetes health and health care quality outcomes. Six studies reported e-messaging or email use–associated outcomes, and two studies reported prescription refill–associated outcomes. The reported health outcomes included the associations of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI. Few studies reported health care utilization outcomes such as office visits, emergency department visits, and hospitalizations. A limited number of studies reported overall quality of care for patients with diabetes who used patient portals. Conclusions The included studies mostly reported improved glycemic control outcomes for patients with diabetes who used patient portals. However, limitations of studying the effects of patient portals exist, which do not guarantee whether the outcomes reported are completely the result of patient portal use or if confounding factors exist. Randomized controlled trials and mixed-methods studies could help understand the mechanisms involved in health outcome improvements and patient portal use among patients with diabetes. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141131. International Registered Report Identifier (IRRID) RR2-10.2196/14975

scholarly journals Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Abrar Alturkistani ◽  
Ambar Qavi ◽  
Philip Emeka Anyanwu ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health Care Quality ◽  
Care Quality ◽  
Risk Of Bias ◽  
Patient Portal ◽  
Patient Portals ◽  
Quality Outcomes ◽  
Patients With Diabetes ◽  
Reported Health

BACKGROUND Patient portal use could help improve the care and health outcomes of patients with diabetes owing to functionalities, such as appointment booking, electronic messaging (e-messaging), and repeat prescription ordering, which enable patient-centered care and improve patient self-management of the disease. OBJECTIVE This review aimed to summarize the evidence regarding patient portal use (portals that are connected to electronic health care records) or patient portal functionality use (eg, appointment booking and e-messaging) and their reported associations with health and health care quality outcomes among adult patients with diabetes. METHODS We searched the MEDLINE, Embase, and Scopus databases and reported the review methodology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent reviewers screened titles and abstracts, and two reviewers assessed the full texts of relevant studies and performed data extraction and quality assessments of the included studies. We used the Cochrane Collaboration Risk of Bias Tool and the National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool to assess the risk of bias of the included studies. Data were summarized through narrative synthesis. RESULTS Twelve studies were included in this review. Five studies reported overall patient portal use and its association with diabetes health and health care quality outcomes. Six studies reported e-messaging or email use–associated outcomes, and two studies reported prescription refill–associated outcomes. The reported health outcomes included the associations of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI. Few studies reported health care utilization outcomes such as office visits, emergency department visits, and hospitalizations. A limited number of studies reported overall quality of care for patients with diabetes who used patient portals. CONCLUSIONS The included studies mostly reported improved glycemic control outcomes for patients with diabetes who used patient portals. However, limitations of studying the effects of patient portals exist, which do not guarantee whether the outcomes reported are completely the result of patient portal use or if confounding factors exist. Randomized controlled trials and mixed-methods studies could help understand the mechanisms involved in health outcome improvements and patient portal use among patients with diabetes. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141131. INTERNATIONAL REGISTERED REPORT RR2-10.2196/14975

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 Patient Portal Functionalities and Uptake: Systematic Review Protocol (Preprint)

2019 ◽  
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. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141131 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/14975

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.

A View on Patient-Reported Outcome Measures

2019 ◽  
pp. 46-49
Author(s):  
François Duhoux ◽  
Rishi Hazarika
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Outcome Measures ◽  
Health Care Quality ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Abstract: Patient-reported outcome measures (PROMs) are being implemented more frequently in the clinical setting to monitor health-related quality of life. The breast cancer standard set developed by the International Consortium for Health Outcomes Measurement (ICHOM) aims at reducing health care costs by preventing medical errors and unnecessary treatments, supporting informed decision-making, and improving health care quality by allowing physicians to compare their health outcomes data to other providers. It encompasses survival, cancer control, and disutility of care outcomes in addition to selected case-mix factors, which are to be collected at baseline, and a combination of multiple PROM tools to capture long-term degree of health outcomes. It can be used for both the early and the metastatic settings. Implementing PROMs is both complex and time-consuming. This or a similar process will likely become mandatory in developed nations, where value-based health care is becoming increasingly popular.

scholarly journals The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review

10.2196/26189 ◽  
2021 ◽  
Vol 23 (9) ◽  
pp. e26189
Author(s):  
Elettra Carini ◽  
Leonardo Villani ◽  
Angelo Maria Pezzullo ◽  
Andrea Gentili ◽  
Andrea Barbara ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Outcomes ◽  
Utilization Rate ◽  
Patient Portal ◽  
System Efficiency ◽  
Patient Attitudes ◽  
Patient Portals ◽  
The Impact ◽  
Health Care Efficiency

Background Patient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear. Objective The aim of this systematic review was to summarize evidence on the impact of patient portals on health outcomes and health care efficiency, and to examine user characteristics, attitudes, and satisfaction. Methods We searched the PubMed and Web of Science databases for articles published from January 1, 2013, to October 31, 2019. Eligible studies were primary studies reporting on the impact of patient portal adoption in relation to health outcomes, health care efficiency, and patient attitudes and satisfaction. We excluded studies where portals were not accessible for patients and pilot studies, with the exception of articles evaluating patient attitudes. Results Overall, 3456 records were screened, and 47 articles were included. Among them, 11 studies addressed health outcomes reporting positive results, such as better monitoring of health status, improved patient-doctor interaction, and improved quality of care. Fifteen studies evaluated the impact of digital patient portals on the utilization of health services with mixed results. Patient characteristics were described in 32 studies, and it was reported that the utilization rate usually increases with age and female gender. Finally, 30 studies described attitudes and defined the main barriers (concerns about privacy and data security, and lack of time) and facilitators (access to clinical data and laboratory results) to the use of a portal. Conclusions Evidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy. It is still unclear whether the use of patient portals improves health service utilization and efficiency.

scholarly journals The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review (Preprint)

2020 ◽  
Author(s):  
Elettra Carini ◽  
Leonardo Villani ◽  
Angelo Maria Pezzullo ◽  
Andrea Gentili ◽  
Andrea Barbara ◽  
...  
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Outcomes ◽  
Utilization Rate ◽  
Patient Portal ◽  
System Efficiency ◽  
Patient Attitudes ◽  
Patient Portals ◽  
The Impact ◽  
Health Care Efficiency

BACKGROUND Patient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear. OBJECTIVE The aim of this systematic review was to summarize evidence on the impact of patient portals on health outcomes and health care efficiency, and to examine user characteristics, attitudes, and satisfaction. METHODS We searched the PubMed and Web of Science databases for articles published from January 1, 2013, to October 31, 2019. Eligible studies were primary studies reporting on the impact of patient portal adoption in relation to health outcomes, health care efficiency, and patient attitudes and satisfaction. We excluded studies where portals were not accessible for patients and pilot studies, with the exception of articles evaluating patient attitudes. RESULTS Overall, 3456 records were screened, and 47 articles were included. Among them, 11 studies addressed health outcomes reporting positive results, such as better monitoring of health status, improved patient-doctor interaction, and improved quality of care. Fifteen studies evaluated the impact of digital patient portals on the utilization of health services with mixed results. Patient characteristics were described in 32 studies, and it was reported that the utilization rate usually increases with age and female gender. Finally, 30 studies described attitudes and defined the main barriers (concerns about privacy and data security, and lack of time) and facilitators (access to clinical data and laboratory results) to the use of a portal. CONCLUSIONS Evidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy. It is still unclear whether the use of patient portals improves health service utilization and efficiency.

A regional collaborative working to improve health care quality, outcomes, and affordability

2017 ◽  
Vol 22 (4) ◽  
pp. 292-301 ◽  
Author(s):  
Virginia Weir
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Washington State ◽  
Private Health Care ◽  
Quality Outcomes ◽  
Content Type ◽  
Improve Health Care ◽  
Improve Health Care Quality ◽  
Improve Health

Purpose The purpose of this paper is to describe the Bree Collaborative’s background, history, structure, and work. Design/methodology/approach The Bree Collaborative was established by the Washington State Legislature to convene public and private health care stakeholders with the goal of identifying specific mechanisms to improve health care quality, outcomes, and affordability. These members are appointed by the Washington State Governor and represent public health care purchasers for Washington State, private health care purchasers (employers and union trusts), health plans, physicians and other health care providers, hospitals, and quality improvement organizations. Members annually select health care services that show high variation in care delivery, that are highly utilized without leading to better care or patient health, or that have known or suspected patient safety issues and develop recommendations for health care improvement. Findings Recommendations are meant to be implemented by the Washington State Health Care Authority and used to set a community standard across the state. Successful implementation depends on several factors including engaged health care purchasers, support from diverse partners, and a health care community willing to put the patient at the center of care. Originality/value Bottom-up, collective action through the Bree Collaborative can help achieve the triple aim for Washington State and should be used as a model nationally and internationally.

scholarly journals Patient Attitudes about Patient Portal Functions

2017 ◽  
Author(s):  
Tamara Sequeira
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Financial Incentives ◽  
Health Care Quality ◽  
Primary Care Patient ◽  
Meaningful Use ◽  
Care Quality ◽  
Patient Portal ◽  
Care Providers

As part the U.S. government’s ongoing efforts to improve health care quality, the Electronic Health Records (EHR) Incentive Program from the Centers for Medicare and Medicaid (CMS) offers financial incentives to eligible health care providers (EP) who adopt, implement, improve, and demonstrate meaningful use of EHR. Beginning 2014, the Stage 2 Meaningful Use core objectives included the ability of patients to use online patient portals to view, download and transmit their health information. As a result, many EP offer a patient portal and encourage sign up, yet not all patients have done so. How patients perceive the patient portal, whether positively or negatively, may affect their adoption and use of the portal. A survey collected attitudes and beliefs about the patient portal from adult, female, primary care patients (n=257). The beliefs of patients who signed up, along with those who had not, were considered within the framework of the theory of planned behavior (TPB) to identify methods to increase patient use of the portal. The TPB correctly predicted portal sign up behavior in attitude (p<0.05) and intention (p<0.05) subscales. Overall, patients viewed portal characteristics as useful, but patients who had signed up identified them as significantly (p<0.01) more useful, and also, were found to have significantly (p<0.05) more education than those who did not sign up. Few methods to increase patient sign up were identified apart from targeted education to promote the portal’s usability and utility. More research is needed to identify potential methods health care providers can use to increase portal use in primary care patient populations. Implications for advanced public health nurse practice, training, policy, and research were identified and recommendations given.

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