Patient portals and quality of care: A literature review using the BC Health Quality Matrix (Preprint)

2020 ◽  
Author(s):  
Alanna Black ◽  
Cathy Le ◽  
Jeffrey Barnett ◽  
Wan-Yun Tsai ◽  
Shawn Sangha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Literature Review ◽  
Public Healthcare ◽  
Original Research ◽  
Patient Access ◽  
Patient Portals ◽  
Health Records ◽  
University Of British Columbia ◽  
The Impact

BACKGROUND Electronic patient portals in healthcare are quickly becoming the preference of clinicians, patients, and caregivers alike. In times where the demand for all things to be online appears limitless, it is no surprise that portals are requested when updating health information systems worldwide. However, there are barriers to implementing online portals and many countries are lagging behind in updating their systems. With the interest in increasing investment in online portals by the Canadian public healthcare system, decision makers should be considering whether patient access to medical records through portals and mobile devices provides any changes to quality of care. OBJECTIVE This literature review examines available research in Canada and globally on health-related online portals and their impact on quality of care and patient access. Also examined are examples of different health portals, including issues or barriers to full implementation and utilization in the health sphere. METHODS A preliminary search was completed in May 2019 to examine the impact of patient portals on quality of care. The resources utilized in the first stage of the review included the University of British Columbia and the Western University library databases, Google, and Google Scholar. Parameters for the search included search terms such as patient portals, personal health records, effectiveness, quality, and access. Recent articles were prioritized, and included articles were generally published in the last five years. The authors reviewed 52 articles or article abstracts and 29 were included in the current review. Of the mixture of Canadian and international references, five are systematic reviews, and 18 are original research studies. RESULTS This study reviewed the available literature and found that there are some positive trends on patient portals’ impact on quality of care, with overall inconclusive or neutral results. Emerging evidence has showcased some benefits of implementing electronic health and patient portals to improve the quality of patient care and access to pertinent health records. However, general consensus is that there is limited available literature that is not considered to be outdated and as such, further investigation is required to support any previous findings. CONCLUSIONS As health care related technology develops further, better quality, quantity, and larger-scale studies will be available in evidence-based research databases. As such, a future follow-up literature review would be relevant to re-examine this topic.

scholarly journals The Impact of Visualization Dashboards on Quality of Care and Clinician Satisfaction: Integrative Literature Review

2018 ◽  
Vol 5 (2) ◽  
pp. e22 ◽  
Author(s):  
Saif Sherif Khairat ◽  
Aniesha Dukkipati ◽  
Heather Alico Lauria ◽  
Thomas Bice ◽  
Debbie Travers ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Literature Review ◽  
Clinician Satisfaction ◽  
The Impact

Impact of promoting patient access to their Electronic Health Care Record: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Archana Tapuria
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Health Information ◽  
Healthcare System ◽  
Security And Privacy ◽  
Self Management ◽  
Cochrane Library ◽  
Patient Access ◽  
Patient Portals ◽  
The Impact

BACKGROUND A significant cost element of healthcare provision are one-to-one interactions with individuals at clinic visits or by phone. HIT (Health Information technology) (https://www.hit.org.uk) and patient-shared EHRs have the potential to decrease these costs, improve access to healthcare data, self-care, quality of care, and health and patient-centred outcome. OBJECTIVE This systematic literature review is aimed at identifying the benefits and issues around promoting patients access to their own Electronic Healthcare Records (EHRs). The purpose is to outline and summarize study results on the impact of patients’ online access to their own EHRs from the primary healthcare centres and hospitals and access to the patient portals. METHODS Searches were conducted in PubMed, MEDLINE, COCHRANE library, CINHAL and Google scholar. Over 2000 papers were screened, and initially filtered based on duplicates, then by reading the titles and finally based on their abstracts. 54 papers were retained, analysed and summarised, of which 24 were studies involving patient portals. Papers were included if patient access to their own EHRs (including patient portals) was the primary intervention used in the study. The search technique used to identify relevant literature for this paper, involved input from 5 experts. RESULTS While 52% authors agree that access to EHRs would be beneficial to patients and the overall healthcare system, a few (18%) critics have highlighted concerns as well. While the benefits range from re-assurance (8%), reduced anxiety (8%), positive impact on consultations (6%), better doctor-patient relationship (10%) and increased awareness and adherence to medicines (8%), most of the concerns are around security and privacy and confidentiality of personal health information along with anxiety in cases of serious illnesses (18%). Using patient portals was found to improve patient outcomes such as medication compliance, achieving blood pressure control, controlling sugar levels and glycaemic control, improving functional status and reduced high-cost healthcare utilisation in patients with chronic conditions, enhance timely patient centred care. These were noted in a range of study populations. In addition, patient portals were found to improve self-reported levels of engagement or activation related to self-management, enhanced knowledge, and improve recovery scores, and organisational efficiencies in a tertiary level mental health care facility. However, three studies out of 24 did not find statistical effect of patient portals on health outcomes. Along with the overall impact of patients’ access to EHR systems, this review has presented the impact of access to patient portals separately as well. CONCLUSIONS This literature review identified some benefits and harms involved in promoting patients’ access to their own EHRs (including the patient portals). This access is often part of government strategies when developing patient-centric self-management elements of a sustainable healthcare system. The findings of this review could give healthcare providers a framework to analyse the benefits offered by promoting patient access to EHRs and decide on the best approach for their own specialities and clinical set up. A robust cost-benefit evaluation of such initiatives along with its impact on major stakeholders within the healthcare system would be essential in understanding the overall impact of such initiatives. Implementation of patient access to their EHRs could help the government address concerns in developing national standards, whilst taking care of local variations and fulfilling the healthcare needs of the population, e.g. to that goal UK Government is committed to making full GP records available online to every patient by 2018. Ultimately, increasing transparency and promoting personal responsibility are key elements of a sustainable healthcare system for future generations.

The power of knowledge: Sharing patient test results electronically to improve quality of care.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 305-305
Author(s):  
Melissa Kaan ◽  
Jason LeMar ◽  
Julie Gilbert ◽  
Erin Rae ◽  
Anna Sampson ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Personal Health Information ◽  
Diagnostic Assessment ◽  
Test Results ◽  
Patient Portals ◽  
Care Services ◽  
Key Informant ◽  
Similar Patient ◽  
The Impact

305 Background: For many patients going through the cancer diagnosis journey, the time from suspicion to diagnosis or rule-out can be a confusing and anxious time. To better support patients during this time, Cancer Care Ontario (CCO) is supporting Diagnostic Assessment Programs (DAPs) and the web-based tool known as the Diagnostic Assessment Program–Electronic Pathway Solution (DAP-EPS). DAPs consist of multi-disciplinary healthcare teams who provide diagnostic and supportive care services in a patient-focused environment, improving access to care and the patient experience. DAPs help manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis and part of this support involves providing access to personal health information through the DAP-EPS. This work was undertaken to determine the best approach to sharing test results with patients, including the type of test results that should be released and the most effective method for sharing these results with patients, from both the patient and provider perspective. Methods: The exploratory project involved conducting key informant interviews with individuals who had been involved with implementing similar patient portals, a targeted literature review, and a series of engagement sessions with physicians to measure the clinical response to this new strategy. Results: Initial discussions with patients and nurses yielded a strong endorsement for releasing all results, with no time delay. Key Informant interviews yielded similar results from the majority of the hospital contacts consulted. The environmental scan did not suggest that releasing results was associated with any adverse patient or provider effects. The physician engagement sessions generated both positive and negative feedback but overall, doctors were comfortable releasing all results, provided there was a delay built into the system. Conclusions: The release of diagnostic test results is seen as a valuable component of quality of care from the perspective of informing and empowering the patient. As the DAP-EPS moves forward with this initiative, the DAP program will continue to monitor the impact that the release of results has on both patients and providers.

scholarly journals Modeling the impact of hospital logistics on quality of care and patient satisfaction: Results of a survey in three public healthcare facilities in Fez, Morocco

2020 ◽  
Vol 13 (2) ◽  
pp. 296
Author(s):  
Youness Frichi ◽  
Fouad Jawab ◽  
Said Boutahari
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Large Scale ◽  
Scale Validation ◽  
Healthcare Facility ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
The Impact ◽  
Physical Accessibility

Purpose: The objective of this research is to examine the role of hospital logistics in improving quality of care and patient satisfaction. Thus, the paper focuses on modeling and evaluating the relationship between these three constructs.Design/methodology/approach: In the present study, hospital logistics was specified as a second-order construct composed of five first-order constructs: physical accessibility, waiting time, consultation time, hospital hotel services, and administrative procedures. A questionnaire was developed and administered face-to-face to 384 hospitalized patients in three public healthcare facilities in Fez-Morocco. Collected data were processed and analyzed deploying the PLS-SEM method and using SmartPLS3 software. Data analysis was carried out by considering two types of patient circuits according to the admission modes in the healthcare facility: Urgent Patients Circuit and Scheduled Patients Circuit. Thus, two PLS-SEM models were evaluated and validated.Findings: Results highlighted the significant impact of hospital logistics on quality and satisfaction. In particular, the results of the two models showed that the most preponderant hospital logistics component is physical accessibility which consists of the availability and accessibility of ambulances, medical and nursing staff, support and guidance staff, technical facilities and equipment, etc. Thus, hospital managers and health system stakeholders should pay particular attention to hospital logistics activities in general and specifically to the physical accessibility to improve the quality of care and patient satisfaction.Research limitations/implications: This study only included patients from three public healthcare facilities in Fez-Morocco. Also, the model variables of hospital logistics construct are restricted and were applied in a specific context. Besides, the sample size was relatively reduced. Thus, results generalization might be limited. Further studies including more patients from other territories and including other logistics components are needed for large-scale validation of the proposed model. Originality/value: The results of this study contribute to the scientific literature on hospital logistics and its role as a lever for quality of care and patient satisfaction.

scholarly journals Impact of sharing electronic health records with patients on the quality and safety of care: a systematic review and narrative synthesis protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e020387 ◽  
Author(s):  
Ana Luisa Neves ◽  
Alexander W Carter ◽  
Lisa Freise ◽  
Liliana Laranjo ◽  
Ara Darzi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Electronic Health Records ◽  
Analytical Framework ◽  
The Body ◽  
Narrative Synthesis ◽  
Health Records ◽  
Electronic Health ◽  
The Impact

IntroductionProviding patients with access to electronic health records (EHRs) has emerged as a promising solution to improve quality of care and safety. As the efforts to develop and implement EHR-based data sharing platforms mature and scale up worldwide, there is a need to evaluate the impact of these interventions and to weigh their relative risks and benefits, in order to inform evidence-based health policies. The aim of this work is to systematically characterise and appraise the demonstrated benefits and risks of sharing EHR with patients, by mapping them across the six domains of quality of care of the Institute of Medicine (IOM) analytical framework (ie, patient-centredness, effectiveness, efficiency, timeliness, equity and safety).Methods and analysisCINAHL, Cochrane, Embase, HMIC, Medline/PubMed and PsycINFO databases will be searched from January 1997 to August 2017. Primary outcomes will include measures related with the six domains of quality of care of the IOM analytical framework. The quality of the studies will be assessed using the Cochrane Risk of Bias Tool, the ROBINS-I Tool and the Drummond’s checklist. A narrative synthesis will be conducted for all included studies. Subgroup analysis will be performed by domain of quality of care domain and by time scale (ie, short-term, medium-term or long-term impact). The body of evidence will be summarised in a Summary of Findings table and its strength assessed according to the GRADE criteria.Ethics and disseminationThis review does not require ethical approval as it will summarise published studies with non-identifiable data. This protocol complies with the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols guidelines. Findings will be disseminated widely through peer-reviewed publication and conference presentations, and patient partners will be included in summarising the research findings into lay summaries and reports.PROSPERO registration numberCRD42017070092.

Evaluating the impact of accreditation and external peer review

2015 ◽  
Vol 28 (8) ◽  
pp. 757-777 ◽  
Author(s):  
Melvin Kilsdonk ◽  
Sabine Siesling ◽  
Renee Otter ◽  
Wim van Harten
Keyword(s):  
Quality Of Care ◽  
Peer Review ◽  
Theoretical Framework ◽  
Control Group ◽  
Original Research ◽  
Content Type ◽  
Research Framework ◽  
Methodological Research ◽  
The Impact

Purpose – Accreditation and external peer review play important roles in assessing and improving healthcare quality worldwide. Evidence on the impact on the quality of care remains indecisive because of programme features and methodological research challenges. The purpose of this paper is to create a general methodological research framework to design future studies in this field. Design/methodology/approach – A literature search on effects of external peer review and accreditation was conducted using PubMed/Medline, Embase and Web of Science. Three researchers independently screened the studies. Only original research papers that studied the impact on the quality of care were included. Studies were evaluated by their objectives and outcomes, study size and analysis entity (hospitals vs patients), theoretical framework, focus of the studied programme, heterogeneity of the study population and presence of a control group. Findings – After careful selection 50 articles were included out of an initial 2,025 retrieved references. Analysis showed a wide variation in methodological characteristics. Most studies are performed cross-sectionally and results are not linked to the programme by a theoretical framework. Originality/value – Based on the methodological characteristics of previous studies the authors propose a general research framework. This framework is intended to support the design of future research to evaluate the effects of accreditation and external peer review on the quality of care.

Reduced influence of affective disorders on perioperative complication rates, length of hospital stay, and healthcare costs following spinal fusion for adolescent idiopathic scoliosis

2019 ◽  
Vol 24 (6) ◽  
pp. 722-727
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Megan Lee ◽  
Adam J. Kundishora ◽  
Christopher S. Hong ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Idiopathic Scoliosis ◽  
Affective Disorder ◽  
Affective Disorders ◽  
Complication Rates ◽  
Total Cost ◽  
Adolescent Patients ◽  
Perioperative Complication ◽  
The Impact

OBJECTIVEIn the past decade, a gradual transition of health policy to value-based healthcare has brought increased attention to measuring the quality of care delivered. In spine surgery, adolescents with scoliosis are a population particularly at risk for depression, anxious feelings, and impaired quality of life related to back pain and cosmetic appearance of the deformity. With the rising prevalence of mental health ailments, it is necessary to evaluate the impact of concurrent affective disorders on patient care after spinal surgery in adolescents. The aim of this study was to investigate the impact that affective disorders have on perioperative complication rates, length of stay (LOS), and total costs in adolescents undergoing elective posterior spinal fusion (PSF) (≥ 4 levels) for idiopathic scoliosis.METHODSA retrospective study of the Kids’ Inpatient Database for the year 2012 was performed. Adolescent patients (age range 10–17 years old) with AIS undergoing elective PSF (≥ 4 levels) were selected using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system. Patients were categorized into 2 groups at discharge: affective disorder or no affective disorder. Patient demographics, comorbidities, complications, LOS, discharge disposition, and total cost were assessed. The primary outcomes were perioperative complication rates, LOS, total cost, and discharge dispositions.RESULTSThere were 3759 adolescents included in this study, of whom 164 (4.4%) were identified with an affective disorder (no affective disorder: n = 3595). Adolescents with affective disorders were significantly older than adolescents with no affective disorders (affective disorder: 14.4 ± 1.9 years vs no affective disorder: 13.9 ± 1.8 years, p = 0.001), and had significantly different proportions of race (p = 0.005). Aside from hospital region (p = 0.016), no other patient- or hospital-level factors differed between the cohorts. Patient comorbidities did not differ significantly between cohorts. The number of vertebral levels involved was similar between the cohorts, with the majority of patients having 9 or more levels involved (affective disorder: 76.8% vs no affective disorder: 79.5%, p = 0.403). Postoperative complications were similar between the cohorts, with no significant difference in the proportion of patients experiencing a postoperative complication (p = 0.079) or number of complications (p = 0.124). The mean length of stay and mean total cost were similar between the cohorts. Moreover, the routine and nonroutine discharge dispositions were also similar between the cohorts, with the majority of patients having routine discharges (affective disorder: 93.9% vs no affective disorder: 94.9%, p = 0.591).CONCLUSIONSThis study suggests that affective disorders may not have a significant impact on surgical outcomes in adolescent patients undergoing surgery for scoliosis in comparison with adults. Further studies are necessary to elucidate how affective disorders affect adolescent patients with idiopathic scoliosis, which may improve provider approach in managing these patients perioperatively and at follow-up in hopes to better the overall patient satisfaction and quality of care delivered.

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