scholarly journals Understanding of and Barriers to Electronic Health Record Patient Portal Access in a Culturally Diverse Pediatric Population (Preprint)

2018 ◽  
Author(s):  
Daniel J Miklin ◽  
Sameera S Vangara ◽  
Alan M Delamater ◽  
Kenneth W Goodman
Keyword(s):  
Culturally Diverse ◽  
Parental Education ◽  
Pediatric Population ◽  
Patient Portal ◽  
Cross Sectional Survey ◽  
Adult Care ◽  
Cross Sectional ◽  
Parental Education Level ◽  
Doctor Patient Communication ◽  
Electronic Health

BACKGROUND Electronic health records (EHRs) have become a standard in the health care setting. In an effort to improve health literacy, foster doctor-patient communication, and ease the transition from adolescent to adult care, our institution created a policy that allows patients aged between 13 and 17 years to have EHR portal access. A literature review revealed predictable differences in portal registration among different ethnicities and socioeconomic statuses. Consequently, a cross-sectional survey was developed to investigate barriers to EHR portal access in a sample of culturally diverse adolescents. OBJECTIVE The aim of this study was to assess for barriers to EHR portal access in a culturally diverse adolescent population. METHODS A 42-item anonymous survey was completed by 97 adolescents aged between 13 and 18 years, attending general pediatrics clinics. The results were analyzed using descriptive statistics and t tests. RESULTS The average participant age was 15.5 (SD 1.5) years with 60% (58/97) male and 40% (39/97) female. Participants were 44% (43/97) black, 41% (40/97) Hispanic, 9% (9/97) Caucasian, 3% (3/97) Asian, and 2% (2/97) others. There were statistically significant differences in perceptions of confidentiality in age (13 to 15 years vs 16 to 18 years; P=.001) and insurance status (government vs private; P=.012) but not in gender, ethnicity, or parental education level. Younger adolescents with governmental insurance were more confident in the level of confidentiality with their physician. A total of 94% of participants had heard of the term EHR, but only 55% were familiar with its function. Furthermore, 77% of patients primarily accessed the internet through phones, and 50% of participants knew that patients aged under 18 years could obtain care for mental health, substance abuse, sexual health, and pregnancy. CONCLUSIONS This research has identified gaps in EHR technology with regard to the pediatric patient population. The results of our survey show that adolescents may have misconceptions regarding the doctor-patient relationship, their ability to obtain care, and the modalities present in an EHR. As technology progresses, it is essential to have a deeper understanding of adolescents’ perceptions of confidentiality, technology, and available resources to design an EHR system that encourages patient education and communication while limiting barriers to care.

scholarly journals A Cross-Sectional Survey on Telemedicine Use for Doctor-Patient Communication

Cureus ◽  
2020 ◽  
Author(s):  
Aelia Akbar ◽  
Aqsa Iqbal ◽  
Dominic Gaziano ◽  
Filip Gasior ◽  
Ayesha J Zaidi ◽  
...  
Keyword(s):  
Patient Communication ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Doctor Patient Communication

scholarly journals Electronic Health Use in the European Union and the Effect of Multimorbidity: Cross-Sectional Survey (Preprint)

2017 ◽  
Author(s):  
Francisco Lupiáñez-Villanueva ◽  
Dimitra Anastasiadou ◽  
Cristiano Codagnone ◽  
Roberto Nuño-Solinís ◽  
Maria Begona Garcia-Zapirain Soto
Keyword(s):  
Health Care Professionals ◽  
Online Survey ◽  
New Technologies ◽  
Cost Effective ◽  
Health Problems ◽  
Exploratory Research ◽  
The European Union ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Electronic Health

BACKGROUND Multimorbidity is becoming increasingly common and is a leading challenge currently faced by societies with aging populations. The presence of multimorbidity requires patients to coordinate, understand, and use the information obtained from different health care professionals, while simultaneously striving to distinguish the symptoms of different diseases and self-manage their sometimes conflicting health problems. Electronic health (eHealth) tools provide a means to disseminate health information and education for both patients and health professionals and hold promise for more efficient and cost-effective care processes. OBJECTIVE The aim of this study was to analyze the use of eHealth tools, taking into account the citizens’ sociodemographic and clinical characteristics, and above all, the presence of multimorbidity. METHODS Cross-sectional and exploratory research was conducted using online survey data from July 2011 to August 2011. Participants included a total of 14,000 citizens from 14 European countries aged 16 to 74 years, who had used an eHealth tool in the past 3 months. The variables studied were sociodemographic variables of the participants, the questionnaire items assessing the frequency of using eHealth tools, the degree of morbidity, and the eHealth adoption gradient. Chi-square tests were conducted to examine the relationship between the sociodemographic and clinical variables of participants and the group the participants were assigned to according to their frequency of eHealth use (eHealth user group). A one-way analysis of variance (ANOVA) allowed for assessing the differences in the eHealth adoption gradient average between different groups of individuals according to their morbidity level. A two-way between-groups ANOVA was performed to explore the effects of multimorbidity and age group on the eHealth adoption gradient. RESULTS According to the eHealth adoption gradient, most participants (68.15%, 9541/14,000) were labeled as rare users, with the majority of them (55.1%, 508/921) being in the age range of 25 to 54 years, with upper secondary education (50.3%, 464/921), currently employed (49.3%, 454/921), and living in medium-sized cities (40.7%, 375/921). Results of the one-way ANOVA showed that the number of health problems significantly affected the use of eHealth tools (F2,13996=11.584; P<.001). The two-way ANOVA demonstrated that there was a statistically significant interaction between the effects of age and number of health problems on the eHealth adoption gradient (F4,11991=7.936; P<.001). CONCLUSIONS The eHealth adoption gradient has proven to be a reliable way to measure different aspects of eHealth use. Multimorbidity is associated with a more intense use of eHealth, with younger Internet users using new technologies for health purposes more frequently than older groups with the same level of morbidity. These findings suggest the need to consider different strategies aimed at making eHealth tools more sensitive to the characteristics of older populations to reduce digital disadvantages.

scholarly journals A cross sectional survey in paediatricians pertaining to management of functional gastrointestinal disorders in infants: Indian perspectives

2020 ◽  
Vol 7 (10) ◽  
pp. 2015
Author(s):  
Shrish Bhatnagar ◽  
Roshan R. Mane ◽  
Irfan A. Shaikh ◽  
Ganesh Kadhe
Keyword(s):  
Quality Of Life ◽  
Parental Education ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Disorders ◽  
Cross Sectional Survey ◽  
Management Options ◽  
Cross Sectional ◽  
Breastfed Infants ◽  
Best Management

Background: Functional gastrointestinal disorders (FGIDs) in infants and toddlers possess extensive burden to the parents and healthcare professionals. Guidelines addressing the practices in diagnosis and management of FGIDs in infants in Indian subcontinent is unavailable. Hence this study assessed current knowledge, attitude and practice of pediatricians in diagnosis and treatment of FGIDs.Methods: A cross-sectional survey based on a structured questionnaire assessed pediatrician’s knowledge about prevalence and profile of most common GI disorders in pediatric age groups (birth to 12 months), association of FGIDs with different feeding practices, impact of FGID on quality of life, various management options and physician preferred method of treatment.Results: Colic was rated as the most common GI disorder, followed by gassiness/fussiness, regurgitation and constipation. About 59% pediatricians come across FGIDs more in formula-fed infants compared to breastfed infants (4.2%) and 93.9% pediatricians affirm that FGIDs affect quality of life. Approximately 91% pediatricians believed reassurance and education was the best management option, which was also reported as the preferred mode of management by about 89% pediatricians, whereas pharmacological therapies were the least preferred (1.6%). For breastfed infants suffering with regurgitation, colic or constipation, majority pediatricians opted for switching to 100% whey partially hydrolysed protein formula; sequentially followed by use of pre/probiotics and switch to extensively hydrolyzed protein formula.Conclusions: Parental education and reassurance offer an ideal mode of management of FGIDs. Partially hydrolysed protein formula may be considered one of the best management options irrespective of the FGID condition in infants who are breastfeed.

scholarly journals Psychoeducational Characteristics of Children with Hypohidrotic Ectodermal Dysplasia

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Rolanda A. Maxim ◽  
Samuel H. Zinner ◽  
Hisako Matsuo ◽  
Theresa M. Prosser ◽  
Mary Fete ◽  
...  
Keyword(s):  
Parental Education ◽  
Adaptive Functioning ◽  
Ectodermal Dysplasia ◽  
Educational Achievement ◽  
Cross Sectional Study ◽  
Hypohidrotic Ectodermal Dysplasia ◽  
Cross Sectional ◽  
Parental Education Level ◽  
Increased Risk ◽  
Composite Scores

Objective. Hypohidrotic ectodermal dysplasia (HED) is an X-linked hereditary disorder characterized by hypohidrosis, hypotrichosis, and anomalous dentition. Estimates of up to 50% of affected children having intellectual disability are controversial.Method. In a cross-sectional study, 45 youth with HED (77% males, mean age 9.75 years) and 59 matched unaffected controls (70% males, mean age 9.79 years) were administered the Kaufman Brief Intelligence Test and the Kaufman Test of Educational Achievement, and their parents completed standardized neurodevelopmental and behavioral measures, educational, and health-related information regarding their child, as well as standardized and nonstandardized data regarding socioeconomic information for their family.Results. There were no statistically significant differences between the two groups in intelligence quotient composite and educational achievement scores, suggesting absence of learning disability in either group. No gender differences within or between groups were found on any performance measures. Among affected youth, parental education level correlated positively with (1) cognitive vocabulary scores and cognitive composite scores; (2) educational achievement for mathematics, reading, and composite scores.Conclusion. Youth affected with HED and unaffected matched peers have similar profiles on standardized measures of cognition, educational achievement, and adaptive functioning although children with HED may be at increased risk for ADHD.

scholarly journals Attitude of physiotherapists toward electronic health record in Croatia

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Manuela Filipec ◽  
Gordana Brumini
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Health Record ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Level Of Education ◽  
Health Care Institutions ◽  
Chi Square Test ◽  
Electronic Health

Abstract Background Electronic health record can facilitate everyday clinical practice of physiotherapists. The aim of this study is to determine attitude of physiotherapists towards implementation of information technology in their work and the differences in attitude in relation to gender, age, level of education and type of health institutions. Methods This study is a cross-sectional survey of Croatian physiotherapists. The questionnaire ″Attitude of physiotherapists towards implementation of electronic health record included 12 items scored on a Likert-type scale from 1 to 5 and presented the award values as “Disagree”, “Neither agree nor disagree” and “Agree”. Croatian physiotherapists were (n = 267) recruited from 13 health care institutions. For analysis chi square test, t-test, one-way analysis of variance and as a post-hoc Tukey test were used. Results Explanatory factorial analysis confirmed two factors: Satisfaction in the work of physiotherapists using computers (SAT) and Necessity of computers in the work of physiotherapists (NEC). Most physiotherapists agree on (SAT) (47.9%) and on (NEC) (51.3%). Male physiotherapists were significantly more likely to disagree with statements related to SAT (p < 0.001) and NEC (p = 0.035) than female physiotherapists. Physiotherapists aged between 46 and 55 years were significantly more like to disagree on NEC in comparison to all the other groups of participants (p < 0.001). Physiotherapists with secondary school degree were significantly more like to disagree on NEC as compared with participants with bachelor’s degree (p = 0.009), as well as in comparison with physiotherapists with a university degree (p = 0.002). Most of the physiotherapists who are employed in Clinical hospitals and in the Speciality hospital agree with that statement (all p > 0.05). Conclusion The attitude of Croatian physiotherapists towards electronic health record differs according to the age, gender, level of education and type of health care institutions. This finding can facilitate implementation of electronic health record in physiotherapy. Trial registration Not applicable.

scholarly journals Nationwide survey of patients’ and doctors’ perceptions of what is needed in doctor - patient communication in a Southeast Asian context

2020 ◽  
Author(s):  
Trung Quang Tran ◽  
Jan van Dalen ◽  
Albert Scherpbier ◽  
Dung van Do ◽  
E. Pamela Wright
Keyword(s):  
Medical Training ◽  
Southeast Asian ◽  
Patient Communication ◽  
Western World ◽  
Communication Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Good Doctor ◽  
Doctor Patient Communication ◽  
Key Skills

Abstract Background Asian countries are trying to apply the partnership model in doctor-patient communication that has been effectively applied in Western countries. The study aimed to investigate whether communication model used in the Western world are appropriate in Southeast Asia and to identify key items in doctor-patient communication that should be included in a doctor-patient communication model for training in Vietnam (a Southeast Asian country).Methods In six provinces, collaborating medical schools collected data from 480 patients interviewed using a structured guideline after a consultation session and from 473 doctors using a cross-sectional survey on how they conduct consultation sessions with patients. Data collection tools covered a list of communication skills based on Western models, adapted to fit with local legislation.Results Both patients and doctors considered most elements in the list necessary for good doctor-patient communication. Both also felt that while actual communication was generally good, there was also room for improvements. Furthermore, the doctors had higher expectations than the patients. Four items in the Western model for doctor-patient communication, all promoting the partnership relation between them, appeared to have lower priority for both patients and doctors in Vietnam.Conclusion The communication model used in the Western world could be applied in Vietnam with minor adaptations. Increasing patients’ understanding of their partner role needs to be considered. The implications for medical training in universities are to focus first on the key skills perceived as needed to be strengthened by both doctors and patients. In the longer term, all of these items should be included in the training to prepare for the future.

scholarly journals Patient Portal Use, Perceptions of Electronic Health Record Value, and Self-Rated Primary Care Quality Among Older Adults: Cross-sectional Survey (Preprint)

2020 ◽  
Author(s):  
Dori A Cross ◽  
Zachary Levin ◽  
Minakshi Raj
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Electronic Health Record ◽  
Care Quality ◽  
Health Record ◽  
Patient Portal ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Value Perception ◽  
Primary Care Quality

BACKGROUND Older adults are increasingly accessing information and communicating using patient-facing portals available through their providers’ electronic health record (EHR). Most theories of technology acceptance and use suggest that patients’ overall satisfaction with care should be independent of their chosen level of portal engagement. However, achieving expected benefits of portal use depends on demonstrated support from providers to meet these expectations. This is especially true among older adults, who may require more guidance. However, little is known about whether misalignment of expectations around technology-facilitated care is associated with lower perceptions of care quality. OBJECTIVE The aims of this study were to analyze whether older adults’ assessment of primary care quality differs across levels of patient portal engagement and whether perceptions of how well their provider uses the EHR to support care moderates this relationship. METHODS We conducted a cross-sectional survey analysis of 158 older adults over the age of 65 (average age 71.4 years) across Michigan using a 13-measure composite of self-assessed health care quality. Portal use was categorized as none, moderate (use of 1-3 functionalities), or extensive (use of 4-7 functionalities). EHR value perception was measured by asking respondents how they felt their doctor’s EHR use improved the patient–provider relationship. RESULTS Moderate portal users, compared to those who were extensive users, had lower estimated care quality (–0.214 on 4-point scale; <i>P</i>=.03). Differences between extensive portal users and nonportal users were not significant. Quality perception was only particularly low among moderate portal users with low EHR value perception; those with high EHR value perception rated quality similarly to other portal user groups. CONCLUSIONS Older adults who are moderate portal users are the least satisfied with their care, and the most sensitive to perceptions of how well their provider uses the EHR to support the relationship. Encouraging portal use without compromising perceptions of quality requires thinking beyond patient-focused education. Achieving value from use of patient-facing technologies with older adults is contingent upon matched organizational investments that support technology-enabled care delivery. Providers and staff need policies and practices that demonstrate technology adeptness. Older adults may need more tailored signaling and accommodation for technology to be maximally impactful.

scholarly journals Supporting the Implementation of Connected Care Technologies in the Veterans Health Administration: Cross-Sectional Survey Findings from the Veterans Engagement with Technology Collaborative (VET-C) Cohort

10.2196/21214 ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. e21214
Author(s):  
Bella Etingen ◽  
Daniel J Amante ◽  
Rachael N Martinez ◽  
Bridget M Smith ◽  
Stephanie L Shimada ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Veterans Health Administration ◽  
Advanced Degree ◽  
Patient Portal ◽  
Veterans Health ◽  
Health Administration ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Records

Background Widespread adoption, use, and integration of patient-facing technologies into the workflow of health care systems has been slow, thus limiting the realization of their potential. A growing body of work has focused on how best to promote adoption and use of these technologies and measure their impacts on processes of care and outcomes. This body of work currently suffers from limitations (eg, cross-sectional analyses, limited patient-generated data linked with clinical records) and would benefit from institutional infrastructure to enhance available data and integrate the voice of the patient into implementation and evaluation efforts. Objective The Veterans Health Administration (VHA) has launched an initiative called the Veterans Engagement with Technology Collaborative cohort to directly address these challenges. This paper reports the process by which the cohort was developed and describes the baseline data being collected from cohort members. The overarching goal of the Veterans Engagement with Technology Collaborative cohort is to directly engage veterans in the evaluation of new VHA patient-facing technologies and in so doing, to create new infrastructure to support related quality improvement and evaluation activities. Methods Inclusion criteria for veterans to be eligible for membership in the cohort included being an active user of VHA health care services, having a mobile phone, and being an established user of existing VHA patient-facing technologies as represented by use of the secure messaging feature of VHA’s patient portal. Between 2017 and 2018, we recruited veterans who met these criteria and administered a survey to them over the telephone. Results The majority of participants (N=2727) were male (2268/2727, 83.2%), White (2226/2727, 81.6%), living in their own apartment or house (2519/2696, 93.4%), and had completed some college (1176/2701, 43.5%) or an advanced degree (1178/2701, 43.6%). Cohort members were 59.9 years old, on average. The majority self-reported their health status as being good (1055/2725, 38.7%) or very good (524/2725, 19.2%). Most cohort members owned a personal computer (2609/2725, 95.7%), tablet computer (1616/2716, 59.5%), and/or smartphone (2438/2722, 89.6%). Conclusions The Veterans Engagement with Technology Collaborative cohort is an example of a VHA learning health care system initiative designed to support the data-driven implementation of patient-facing technologies into practice and measurement of their impacts. With this initiative, VHA is building capacity for future, rapid, rigorous evaluation and quality improvement efforts to enhance understanding of the adoption, use, and impact of patient-facing technologies.

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