scholarly journals Sharing hospital outpatient visit notes with patients in the Netherlands: a mixed-methods study on the anticipated benefits and concerns of Open Notes (Preprint)

Author(s):  
Sharon L. Janssen ◽  
Nynke Venema-Taat ◽  
Stephanie Medlock
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

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.


Author(s):  
Rosa Naomi Minderhout ◽  
Martine C. Baksteen ◽  
Mattijs E. Numans ◽  
Marc A. Bruijnzeels ◽  
Hedwig M.M. Vos

Author(s):  
Ada van den Bos-Boon ◽  
Susan Hekman ◽  
Robert-Jan Houmes ◽  
Lilian Vloet ◽  
Saskia Gischler ◽  
...  

2020 ◽  
Author(s):  
Jodi Sturge ◽  
Louise Meijering ◽  
C Allyson Jones ◽  
Mirjam Garvelink ◽  
Danielle Caron ◽  
...  

BACKGROUND Understanding the mobility patterns and experiences of older adults with memory problems living at home has the potential to improve autonomy and inform shared decision making (SDM) about their housing options. OBJECTIVE We aim to (1) assess the mobility patterns and experiences of older adults with memory problems, (2) co-design an electronic decision support intervention (e-DSI) that integrates users’ mobility patterns and experiences, (3) explore their intention to use an e-DSI to support autonomy at home, and (4) inform future SDM processes about housing options. METHODS Informed by the Good Reporting of A Mixed Methods Study (GRAMMS) reporting guidelines, we will conduct a 3-year, multipronged mixed methods study in Canada, Sweden, and the Netherlands. For Phase 1, we will recruit a convenience sample of 20 older adults living at home with memory problems from clinical and community settings in each country, for a total of 60 participants. We will ask participants to record their mobility patterns outside their home for 14 days using a GPS tracker and a travel diary; in addition, we will conduct a walking interview and a final debrief interview after 14 days. For Phase 2, referring to results from the first phase, we will conduct one user-centered co-design process per country with older adults with memory issues, caregivers, health care professionals, and information technology representatives informed by the Double Diamond method. We will ask participants how personalized information about mobility patterns and experiences could be added to an existing e-DSI and how this information could inform SDM about housing options. For Phase 3, using online web-based surveys, we will invite 210 older adults with memory problems and/or their caregivers, split equally across the three countries, to use the e-DSI and provide feedback on its strengths and limitations. Finally, in Phase 4, we will triangulate and compare data from all phases and countries to inform a stakeholder meeting where an action plan will be developed. RESULTS The study opened for recruitment in the Netherlands in November 2018 and in Canada and Sweden in December 2019. Data collection will be completed by April 2021. CONCLUSIONS This project will explore how e-DSIs can integrate the mobility patterns and mobility experiences of older adults with memory problems in three countries, improve older adults’ autonomy, and, ultimately, inform SDM about housing options. CLINICALTRIAL ClinicalTrials.gov NCT04267484; https://clinicaltrials.gov/ct2/show/NCT04267484 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19244


2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Leanne MSG van Heur ◽  
Leo HB Baur ◽  
Marleen Tent ◽  
Cara LB Lodewijks-van der Bolt ◽  
Marjolijn Streppel ◽  
...  

Author(s):  
Patrick PT Jeurissen ◽  
Niek Klazinga ◽  
Luc Hagenaars

The burden of registrations for professionals should be more firmly on the policy agenda. In a rigorous study, Marieke Zegers and colleagues make a compelling argument why that should be the case. In Dutch hospitals, the average professional spends 52.3 minutes a day on quality registries and monitoring instruments. Many more administrative duties exist. These represent substantial resources and ultimately could become a drag on the intrinsic motivation of the care professions. We agree with Zegers et al that we are in need for more operational efficiency. However, the issue at hand is very complex and also intensely connected to the entire healthcare system and its different levels. More operational efficiency alone will not solve this problem. We are also in need for better governance of data-issues at the macro-system level.


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