scholarly journals Patient Portal Use in Diabetes Management: Literature Review (Preprint)

2018 ◽  
Author(s):  
Ran Sun ◽  
Mary T Korytkowski ◽  
Susan M Sereika ◽  
Melissa I Saul ◽  
Dan Li ◽  
...  

BACKGROUND Health information technology tools (eg, patient portals) have the potential to promote engagement, improve patient-provider communication, and enhance clinical outcomes in the management of chronic disorders such as diabetes mellitus (DM). OBJECTIVES The aim of this study was to report the findings of a literature review of studies reporting patient portal use by individuals with type 1 or type 2 DM. We examined the association of the patient portal use with DM-related outcomes and identified opportunities for further improvement in DM management. METHODS Electronic literature search was conducted through PubMed and PsycINFO databases. The keywords used were “patient portal*,” “web portal,” “personal health record,” and “diabetes.” Inclusion criteria included (1) published in the past 10 years, (2) used English language, (3) restricted to age ≥18 years, and (4) available in full text. RESULTS This review included 6 randomized controlled trials, 16 observational, 4 qualitative, and 4 mixed-methods studies. The results of these studies revealed that 29% to 46% of patients with DM have registered for a portal account, with 27% to 76% of these patients actually using the portal at least once during the study period. Portal use was associated with the following factors: personal traits (eg, sociodemographics, clinical characteristics, health literacy), technology (eg, functionality, usability), and provider engagement. Inconsistent findings were observed regarding the association of patient portal use with DM-related clinical and psychological outcomes. CONCLUSIONS Barriers to use of the patient portal were identified among patients and providers. Future investigations into strategies that engage both physicians and patients in use of a patient portal to improve patient outcomes are needed.


2015 ◽  
Vol 7 (2) ◽  
pp. 172 ◽  
Author(s):  
Yulong Gu ◽  
Martin Orr ◽  
Jim Warren

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.



2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 31-31
Author(s):  
Debra A. Patt ◽  
Jennifer Trageser ◽  
Jeffrey A. Howard ◽  
Max Rush ◽  
Cara Heiman ◽  
...  

31 Background: Our large network of oncology practices (PRs) launched a health IT (HIT) patient portal (PP) to improve patient (PT) access to clinical information (CI) and serve as a platform to enhance PR-to-PT communication (C). Methods: A team of HIT specialists and oncologists engaged in development of the PP to develop a platform to facilitate PR-to-PT C, satisfy meaningful use (MU) requirements, and have brand identification (ID) for PRs. Workflow planning for implementation was conducted including ID and education of key participants at PRs. Educational signage was posted at PRs during initiation partnered with information at check-in at clinic visits to inform PTs about PP benefits and registration steps. After consent was obtained, pts were invited by email to the PP and could access their PP and view and download their secure CI. A review of support calls from both PR personnel and pts highlighted opportunities for enhanced PP engagement. Enrollment (E) was captured monthly. Results: From April 2012 to June 2013 more than 34,000 pts have enrolled in the PP across over 47 PRs (Table). In addition, inclusion of the PR brand and removing extraneous data capture during E are critical to success. Comparing E data from April 2012 to April 2013 after increased PR brand ID and reduction of pt validation changes were implemented, there was an increase of 13% of opened Is and 22% increase in Es. Conclusions: By engaging a development team, and strategically planning content dissemination and education around initiation, implementation of the PP was widely utilized throughout the PRs. By monitoring adoption rates and capturing the PT feedback, incremental enhancements can positively affect PT engagement with PRs. This functional mechanism can now serve as a platform to facilitate C between PRs and PTs, fulfill MU requirements, and plan future dissemination of educational content. [Table: see text]



2017 ◽  
Author(s):  
Jordan M Alpert ◽  
Bonny B Morris ◽  
Maria D Thomson ◽  
Khalid Matin ◽  
Richard F Brown

BACKGROUND Providing patients with unrestricted access to their electronic medical records through patient portals has impacted patient-provider communication and patients’ personal health knowledge. However, little is known about how patient portals are used in oncology. OBJECTIVE The aim of this study was to understand attitudes of the portal’s adoption for oncology and to identify the advantages and disadvantages of using the portal to communicate and view medical information. METHODS In-depth semistructured interviews were conducted with 60 participants: 35 patients, 13 oncologists, and 12 medical informaticists. Interviews were recorded, transcribed, and thematically analyzed to identify critical incidents and general attitudes encountered by participants. RESULTS Two primary themes were discovered: (1) implementation practices influence attitudes, in which the decision-making and execution process of introducing portals throughout the hospital did not include the input of oncologists. Lack of oncologists’ involvement led to a lack of knowledge about portal functionality, such as not knowing the time period when test results would be disclosed to patients; (2) perceptions of portals as communication tools varies by user type, meaning that each participant group (patients, oncologists, and medical informaticists) had varied opinions about how the portal should be used to transmit and receive information. Oncologists and medical informaticists had difficulty understanding one another’s culture and communication processes in their fields, while patients had preferences for how they would like to receive communication, but it largely depended upon the type of test being disclosed. CONCLUSIONS The majority of patients (54%, 19/35) who participated in this study viewed lab results or scan reports via the portal before being contacted by a clinician. Most were relatively comfortable with this manner of disclosure but still preferred face-to-face or telephone communication. Findings from this study indicate that portal education is needed for both patients and oncologists, especially when portals are implemented across entire health systems since highly specialized areas of medicine may have unique needs and uses. Patient portals in oncology can potentially alter the way diagnoses are delivered and how patients and oncologists communicate. Therefore, communication about the portal should be established during initial consultations so patients can decide whether they want to be informed in such a manner.



JMIR Diabetes ◽  
10.2196/11199 ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. e11199 ◽  
Author(s):  
Ran Sun ◽  
Mary T Korytkowski ◽  
Susan M Sereika ◽  
Melissa I Saul ◽  
Dan Li ◽  
...  


2018 ◽  
Vol 24 (5) ◽  
pp. 404 ◽  
Author(s):  
Phoebe Elers ◽  
Frances Nelson

Research has shown that patient portals can improve patient–provider communication and patient satisfaction. Yet few studies have examined patient portals in New Zealand. In this study, GPs from nine primary care practices were interviewed using a semi-structured interview technique to ascertain how they thought patient portals influence the delivery of primary healthcare. The interviews were transcribed and thematically analysed. The three themes detected were: patient portal usage, health information seeking and the changing consultation. Although most of the participants indicated that patient portals are not being effectively utilised, they were optimistic about the role of information technology in primary healthcare for providing accurate information and to connect with patients in modern terms. Participants reported that some patients have become more informed and compliant with medical treatments and interventions after using patient portals. It seems that patient portals have the potential to enhance patient–provider relationships and help patients manage more aspects of their health care.



2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23062-e23062
Author(s):  
Linda A. Jacobs ◽  
Abigail N. Blauch ◽  
Donna A. Pucci ◽  
Angela DeMichele ◽  
Steven C Palmer

e23062 Background: PRO assessment has the potential to improve patient-provider communication, yet has been difficult to implement in practice. We developed and pilot-tested a web-based PRO assessment (Assessing Concerns at End of Treatment, ACE) within an existing cancer survivorship clinic to ascertain practicality, usability, and uptake by both patients and providers. Methods: ACE is a brief PRO assessment that interfaces with the patient-portal and delivers results into the electronic medical record (EMR). Prior to visit eligible patients were asked to complete a series of measures including a 19-item instrument assessing severity of physical and emotional difficulties and desire for assistance. These results were then made available to providers during the visit through the EMR. Patients were provided up to 3 reminder calls/emails to prompt completion. Eligibility included a breast cancer (BC) diagnosis up to 5 years prior to a scheduled survivorship visit, no current cancer treatment aside from hormonal therapies, and access to the internet. Results: Over 27-months 779 eligible BC survivors were approached and asked to participate, and 566 (73%) agreed. The ACE survey was completed by 332 (59%) of these patients prior to their visit. The most common difficulties reported were Fatigue (86.6%), Worry (75.4%), Difficulty Sleeping (74.8%), and Pain (72.2%). Patients most commonly requested assistance for Aching Joints (31.2%), Fatigue (29%), Difficulty Sleeping (28.6%), and Weight Gain (25.7%). Providers reported being burdened by the information provided and few referrals were made in response to ACE. Technical difficulties were encountered frequently and required more maintenance than initially anticipated. Conclusions: Most eligible patients agreed to complete ACE, however a minority actually did so despite repeated contacts. Lack of buy-in from providers was an obstacle, as were technical difficulties. Difficulties with physical and emotional issues were common, but desire for assistance was less so, and resulted in few referrals. Although practicable, questions remain about the cost vs. benefit of a web-based PRO assessment with survivors.



2017 ◽  
Vol 3 (3) ◽  
pp. 152-156 ◽  
Author(s):  
Heather Leisy ◽  
Meleha Ahmad ◽  
Gabriella Guevara ◽  
Roland Theodore Smith

IntroductionPatient portals or personal health records allow patients to access their health information and communicate with their physician’s office outside of their clinic visit. As such, their use has been observed to increase patient engagement and decrease administrative costs. Despite these advantages, patient adoption and successful use of patient portals remains low. Here we assess the feasibility and efficacy of an iBooks-based tutorial in increasing comfort and compliance with personal health record use.MethodsWe created and published a 5-min iBooks-based tutorial describing our institution’s patient portal features. We administered the tutorial, along with presurvey and postsurvey, to ophthalmology clinic patients.ResultsOf 70 participants, 50% had already registered for our institution’s patient portal. Registered patients had viewed labs (74%, n=26) and messaged providers (57%, n=20) but rarely used other features such as scheduling appointments (17%, n=6) or requesting refills (26%, n=9). After the tutorial, comfort levels in knowledge on how to use portal features increased by 20%–80%, depending on portal feature and registration status. Main barriers to portal usage were preference for telephone-based communication (26%, n=18) and knowledge of portal existence (21%, n=15). The majority (86%, n=60) agreed the tutorial would increase their utilisation of the patient portal.ConclusionTutorials increase knowledge and awareness of patient portal features, allowing these features to be fully used. An iBooks-based approach allows patients to successfully access and use tutorial content outside of the clinic.



Lupus ◽  
2020 ◽  
pp. 096120332096570
Author(s):  
Juliana P Ocanha-Xavier ◽  
Camila O Cola-Senra ◽  
Jose Candido C Xavier-Junior

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.



2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1402.1-1402
Author(s):  
R. Pinheiro Torres ◽  
M. H. Fernandes Lourenco ◽  
A. Neto ◽  
F. Pimentel Dos Santos ◽  
I. Silva ◽  
...  

Background:Juvenile idiopathic arthritis (JIA), one of the most common chronic diseases in children, can be classified in seven different categories according to its onset presentation. Concerns about pregnancy outcomes play a secondary role in disease approach. However, recent data showed an increased risk of pre-term birth in women with JIA instead the small patient samples analysed.Objectives:In this review, our aim is to describe the current available knowledge on JIA adverse, maternal and fetal, outcomes.Methods:A systematic literature review was conducted since January of 2000 until December 2020, by searching the PubMed and Embase bibliographic databases. The search was limited to articles in English language, presenting a comparator group (healthy individuals or patients without known auto-immune rheumatic diseases) and at least one clinical outcome of interest. Two independent reviewers screened the titles and abstracts followed by a full-text review to assess papers regarding their eligibility.Results:Ten observational studies out of 1560 references, fulfilled the inclusion criteria, of which, 9 were retrospective and 1 prospective. A total of 6.214 women with JIA (with 6.811 pregnancies) and 18.659.513 healthy controls (with 21.339.194 pregnancies) were included in this review.Concerning maternal outcomes, delivery by caesarian section (CS) was more frequent among JIA women (in 4 out of 6 studies). Pre-eclampsia was referred in 3 out of 6 studies and a higher risk of vaginal bleeding and placenta previa in one additional study. No study found an increased risk for gestational diabetes or hypertension in pregnant women with JIA.Regarding fetal outcomes, 8 studies revealed significantly increased of pre-term birth (only in first births in one study) but one study didn’t show any increased risk. Two studies showed a higher risk of small gestational age (SGA) and in another 2, increased risk for low birth weight (LBW). No evidence of increased risk of major congenital malformations.Conclusion:This systematic review suggests an increased risk for pre-eclampsia, preterm birth, delivery by CS, SGA and LBW, among pregnant women with JIA. Conclusions should be carefully interpreted, giving the heterogeneity of studied populations regarding demography, disease type, disease activity, and prescribed medication.Disclosure of Interests:None declared



2021 ◽  
pp. 875647932110186
Author(s):  
Kimberly Sorrentino

Objective: Continuous improvement is vital to ensuring quality in sonography education. The aim of this literature review was to compile and summarize the current literature on accreditation, credentialing, and quality improvement initiatives in sonography education. Materials & Methods: Four sonography-specific journals and six health science/academic databases were searched using the terms education, sonography, ultrasound, accreditation, credential, and quality. The search was limited to findings in the English language, from 2000 to 2020. Results: The search uncovered only 19 articles on this topic in sonography education. The vast majority of papers focused on quality improvement initiatives, while just a few concentrated on accreditation or credentialing. Conclusion: Much of the contemporary sonography educational literature focuses on clinical, lab, or didactic quality improvement initiatives. Overall, it is clear that more research is needed in the field of sonography education. This review provides examples of quality initiative research in other allied health fields that can be useful guides for future sonography educational research.



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