Building primary healthcare personnels’ support for a patient portal while alleviating eHealth-related stress: Survey study (Preprint)

2021 ◽  
Author(s):  
Iiris Hörhammer ◽  
Sari Kujala ◽  
Pirjo Hilama ◽  
Tarja Heponiemi
Keyword(s):  
Primary Healthcare ◽  
Sustainable Use ◽  
Survey Study ◽  
Healthcare Personnel ◽  
Full Potential ◽  
Patient Portal ◽  
Patient Portals ◽  
Logistic Regression Models ◽  
Implementation Practices ◽  
Related Stress

BACKGROUND Healthcare personnel’s engagement in patient portal implementation is necessary in embedding the use of the portal in everyday practices of a healthcare organization. While portal implementation may raise personnel’s positive expectations of the benefits in patient care, it is often also stressful for them due to increased workloads and disruptions in clinical workflows. An understanding of social and technical factors that build personnel’s support for patient portal implementation and alleviate their eHealth-related stress is therefore needed to realize the full potential of portals. OBJECTIVE The aim of this study was to explore the influence of managerial implementation practices, information technology (IT) usability, and personnel’s eHealth competences on support for patient portal implementation and eHealth-related stress among primary healthcare personnel. METHODS The data were collected through a survey of 919 members of the personnel at two health organizations in Finland. Linear and logistic regression models were fitted to study the associations between the variables. RESULTS The adoption of appropriate implementation practices and usability of the technology can build personnel’s support for a patient portal and alleviate their stress. Personnel’s support is manifested in their promotion of the portal to patients. CONCLUSIONS Healthcare managers are encouraged to consider the good implementation practices as a prerequisite for meaningful and sustainable use of patient portals.

scholarly journals Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study (Preprint)

2020 ◽  
Author(s):  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Amir Alishahi Tabriz ◽  
Christopher M Shea
Keyword(s):  
Patient Characteristics ◽  
Survey Study ◽  
Patient Portal ◽  
Older Individuals ◽  
Patient Portals ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Multiple Variable ◽  
Nationally Representative ◽  
National Trends

BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; <i>P</i>=.01). Older age (OR 1.01, 95% CI 1.00-1.02; <i>P</i>&lt;.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; <i>P</i>&lt;.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; <i>P</i>=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; <i>P</i>&lt;.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; <i>P</i>&lt;.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; <i>P</i>&lt;.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; <i>P</i>&lt;.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.

Patient Portals: Useful for Whom and for What? A Cross-Sectional Analysis of National Survey Data

2021 ◽  
Vol 12 (03) ◽  
pp. 573-581
Author(s):  
Christine M. Swoboda ◽  
Matthew J. DePuccio ◽  
Naleef Fareed ◽  
Ann Scheck McAlearney ◽  
Daniel M. Walker
Keyword(s):  
Chronic Conditions ◽  
Regression Models ◽  
Perceived Usefulness ◽  
Patient Portal ◽  
Patient Portals ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Frequency Of Use ◽  
Bachelor's Degrees ◽  
National Trends

Abstract Background Patients who use patient portals may be more engaged and empowered in their care; however, differences in who accesses patient portals remain. The characteristics of who uses patient portals more frequently and who perceives them as useful may also differ, as well as which functions people use. Objective We assessed the characteristics of patient portal users to examine who uses them more frequently and who perceives them as useful. In addition, we wanted to see if those who use them more frequently or perceive them to be more useful use different functions or more functions of patient portals. Methods Pooled cross-sectional data from 2017 to 2018 Health Information National Trends Survey (HINTS) were used. Ordinal regression models were developed to assess frequency of use and perceived usefulness by demographics, and multivariable logistic regression models were used to examine the association between the use of 10 patient portal functions and frequency of use and perceived usefulness of patient portals. Results The odds of using patient portals more frequently were higher among those with Bachelor's degrees, incomes between $35,000 and $75,000, and those with two or more chronic conditions. Respondents with three or more chronic conditions had higher odds of rating patient portals as useful. Those who used their patient portal 10 or more times in the past year had higher odds of using all functions except for viewing test results compared with those who used their patient portal one to two times per year. Those who rated patient portals as “very useful” had higher odds of using seven of the functions compared with those who rated them “not very”/“not at all useful.” Conclusion It is important to continue to assess usefulness, frequency of use, and overall patient portal function use to identify opportunities to increase patient engagement with patient portals.

scholarly journals Novel Interventions and Assessments Using Patient Portals in Adolescent Research: Confidential Survey Study (Preprint)

2017 ◽  
Author(s):  
Lindsay A Thompson ◽  
Rebeccah Mercado ◽  
Thomas Martinko ◽  
Ratna Acharya
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Intervention Group ◽  
Office Visit ◽  
Survey Study ◽  
Control Group ◽  
Patient Portal ◽  
Parental Consent ◽  
Patient Portals ◽  
Communication Preferences

BACKGROUND While adolescents can receive confidential health care without parental or guardian notification, they are rarely asked about their experiences and opinions regarding their care because participation in research often requires parental consent. Anonymous research with adolescents via confidential patient portals may ameliorate this research gap. OBJECTIVE Because use of a confidential online adolescent patient portal is high at our academic institution, we hypothesized that adolescents would also respond to survey-based research via the portal, especially if asked anonymously and without parental consent. We used a clinical scenario of needing to better understanding adolescent and young adults’ views about their health and health care, including information on a long-acting reversible contraceptive (LARC) to test if and how they will use a portal for research. METHODS Upon receiving Institutional Review Board approval, we sent 2 portal-based surveys about confidential services to 2 groups of females, ages 14 to 25 years, who had attended an adolescent clinic in the past 3 years. This clinic mostly serves Medicaid recipients (80%) and is racially and ethnically diverse with half of patients identifying as African American and roughly 10% Hispanic. The control group was a random sample of female patients who never received a LARC (n=150) and the intervention group included all female adolescents who had received a LARC from the same clinic (n=107). This second sample was manually cross-checked to confirm they had an office visit for this reason. Consenting for themselves, the control group received an email through the patient portal with a link and a request to perform an assessment. The survey for the control group included items assessing health literacy and health communication preferences. The survey for the intervention group included health literacy items as well as items to assess their opinions and perceptions regarding LARCs. We tracked click-through rates and opened messages; each participant received 4 reminders. RESULTS While only 3 participants fully completed either survey, email read rates (29/107 [27.1%] of LARC recipients and 39/150 [26.0%] of controls) were encouraging. Additionally, of those who opened the messages, almost twice as many of the LARC recipients (10/107 [9.3%]) read through the entire survey, while less than half read the entire survey as compared to those who received the survey asking about health literacy and health care preferences (6/150 [4.0%]). CONCLUSIONS The methodology of using adolescent portals for online surveys provides a new avenue for research even though the study did not yield sufficient participation to understand these adolescents’ preferences. Future studies need to test if a different survey topic would engage adolescents or if other methods like text-based reminders would improve participation.

scholarly journals Pharmacy Customers’ Experiences of Use, Usability, and Satisfaction of a Nationwide Patient Portal: Survey Study

10.2196/25368 ◽  
2021 ◽  
Vol 23 (7) ◽  
pp. e25368
Author(s):  
Maria Sääskilahti ◽  
Riitta Ahonen ◽  
Johanna Timonen
Keyword(s):  
Health Care ◽  
Health Information ◽  
Data Privacy ◽  
Health Data ◽  
Survey Study ◽  
Patient Portal ◽  
Data Systems ◽  
Patient Portals ◽  
Privacy And Security ◽  
Chi Square

Background Patient portals have been introduced in several countries in the last few decades. Despite worldwide objectives of introducing patient portals, nationwide portals are rare, and studies about their use are limited. Finland is one of the forerunners in developing nationwide health data systems. A nationwide patient portal, My Kanta, for viewing electronic prescriptions and health data has been phased in, starting in 2010. Objective The aim of this study was to investigate what functions Finnish pharmacy customers use in My Kanta, their perceptions of the service’s usability, and how satisfied users are with My Kanta overall. Methods In spring 2019, questionnaires (N=2866) were distributed from 18 pharmacies of varying size across mainland Finland to adult pharmacy customers purchasing prescription medications for themselves or for their child under 18 years of age. Questions were asked about the use and usability of the patient portal by means of structured and Likert-scale questions. Statistical analyses included frequencies, means, medians, chi-square tests, Fisher exact tests, and Kruskal-Wallis tests. Results In total, 994 completed questionnaires of 2866 delivered questionnaires (34.68%) were returned. The most-used My Kanta functions were browsing prescription information (781/802, 97.4%), records of health care visits (772/802, 96.3%), and results of laboratory tests and x-ray examinations (722/804, 89.8%). Most users (558/793, 70.4%) had also requested a prescription renewal using the service. My Kanta was perceived as easy to log into (772/816, 94.6%) and clear to view (709/808, 87.7%). Most users considered the service useful for monitoring their health information (753/813, 92.6%) and felt that it provides a good overall picture of the medications prescribed to them (711/813, 87.5%). The majority of users found the information recorded about them easy to understand (684/800, 85.5%). Of the users, 16.7% (135/807) disagreed with the statement that the information they were looking for was easy to find. Approximately two-thirds (501/814, 61.5%) of users did not know whether it is easy to view in which pharmacies and health care units their prescription information has been viewed, and over one-third (306/805, 38.0%) did not know whether it is easy to view in which health care units their health information has been processed. Approximately one-fifth of participants (181/805, 22.5%) feared that unauthorized persons might view their information and that their electronically saved prescription and health information might disappear (180/810, 22.2%). In addition, 16.1% (129/799) expressed interest in receiving guidance on My Kanta use. The vast majority of users (719/804, 89.4%) were satisfied with the service overall. Conclusions Pharmacy customers were satisfied with the nationwide patient portal. It was mostly used for browsing e-prescriptions and medical records. Overall, the usability of the service was good. However, users need to be better informed about data privacy and security issues, and guidance on using the portal needs to be improved.

scholarly journals Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study

10.2196/18870 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e18870
Author(s):  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Amir Alishahi Tabriz ◽  
Christopher M Shea
Keyword(s):  
Patient Characteristics ◽  
Survey Study ◽  
Patient Portal ◽  
Older Individuals ◽  
Patient Portals ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Multiple Variable ◽  
Nationally Representative ◽  
National Trends

Background Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. Objective This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. Methods Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. Results The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; P=.01). Older age (OR 1.01, 95% CI 1.00-1.02; P<.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; P<.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; P=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; P<.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; P<.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; P<.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; P<.001) had significantly higher odds of indicating that they were uncomfortable with a computer. Conclusions The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.

scholarly journals Effects of a Web-Based Patient Portal on Patient Satisfaction and Missed Appointment Rates: Survey Study (Preprint)

2020 ◽  
Author(s):  
Timothy A D Graham ◽  
Samina Ali ◽  
Melita Avdagovska ◽  
Mark Ballermann
Keyword(s):  
Health System ◽  
User Satisfaction ◽  
Clinic Visit ◽  
Survey Study ◽  
Relative Reduction ◽  
Patient Portal ◽  
Missed Appointments ◽  
Patient Portals ◽  
Appointment Attendance ◽  
System Use

BACKGROUND Although electronic medical record (EMR)-tethered patient portals are common in other countries, they are still emerging in Canada. OBJECTIVE We aimed to report user satisfaction and the effects of a patient portal on medical appointment attendance in a Canadian cohort of patients within our publicly funded health care system. METHODS Two surveys were deployed, via email, at 2 weeks and 6 months following the first recorded patient portal access. Database audits of visit attendance were used to supplement and cross reference survey data. RESULTS Between January 2016 and July 2018, 4296 patients accessed the patient portal. During the study, 28% (957/3421) consented patient portal users responded to one or more semistructured electronic surveys. Of respondents, 93% (891/957) reported that the patient portal was easy to use, 51% (492/975) reported it saved time when scheduling an appointment, and 40% (382/957) reported that they had to repeat themselves less during appointments. Respondents reported patient portal–related changes in health system use, with 48% (462/957) reporting avoiding a clinic visit and 2.7% (26/957) avoiding an emergency department visit. Across 19,968 visits in clinics where the patient portal was introduced, missed appointments were recorded in 9.5% (858/9021) of non–patient portal user visits, compared with 4.5% (493/9021) for patient portal users, representing a 53% relative reduction in no-show rates. CONCLUSIONS Early experience with an EMR-tethered patient portal showed strong reports of positive patient experience, a self-reported decrease in health system use, and a measured decrease in missed appointment rates. Implications on the expanded use of patient portals requires more quantitative and qualitative study in Canada.

Improving healthcare through digital connection? Findings from a qualitative study about patient portals in New Zealand

2018 ◽  
Vol 24 (5) ◽  
pp. 404 ◽  
Author(s):  
Phoebe Elers ◽  
Frances Nelson
Keyword(s):  
New Zealand ◽  
Primary Healthcare ◽  
Information Seeking ◽  
Structured Interview ◽  
Accurate Information ◽  
Patient Portal ◽  
Patient Portals ◽  
Medical Treatments ◽  
Patient Provider Communication ◽  
Primary Care Practices

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.

scholarly journals Pharmacy Customers’ Experiences of Use, Usability, and Satisfaction of a Nationwide Patient Portal: Survey Study (Preprint)

2020 ◽  
Author(s):  
Maria Sääskilahti ◽  
Riitta Ahonen ◽  
Johanna Timonen
Keyword(s):  
Health Care ◽  
Health Information ◽  
Data Privacy ◽  
Health Data ◽  
Survey Study ◽  
Patient Portal ◽  
Data Systems ◽  
Patient Portals ◽  
Privacy And Security ◽  
Chi Square

BACKGROUND Patient portals have been introduced in several countries in the last few decades. Despite worldwide objectives of introducing patient portals, nationwide portals are rare, and studies about their use are limited. Finland is one of the forerunners in developing nationwide health data systems. A nationwide patient portal, My Kanta, for viewing electronic prescriptions and health data has been phased in, starting in 2010. OBJECTIVE The aim of this study was to investigate what functions Finnish pharmacy customers use in My Kanta, their perceptions of the service’s usability, and how satisfied users are with My Kanta overall. METHODS In spring 2019, questionnaires (N=2866) were distributed from 18 pharmacies of varying size across mainland Finland to adult pharmacy customers purchasing prescription medications for themselves or for their child under 18 years of age. Questions were asked about the use and usability of the patient portal by means of structured and Likert-scale questions. Statistical analyses included frequencies, means, medians, chi-square tests, Fisher exact tests, and Kruskal-Wallis tests. RESULTS In total, 994 completed questionnaires of 2866 delivered questionnaires (34.68%) were returned. The most-used My Kanta functions were browsing prescription information (781/802, 97.4%), records of health care visits (772/802, 96.3%), and results of laboratory tests and x-ray examinations (722/804, 89.8%). Most users (558/793, 70.4%) had also requested a prescription renewal using the service. My Kanta was perceived as easy to log into (772/816, 94.6%) and clear to view (709/808, 87.7%). Most users considered the service useful for monitoring their health information (753/813, 92.6%) and felt that it provides a good overall picture of the medications prescribed to them (711/813, 87.5%). The majority of users found the information recorded about them easy to understand (684/800, 85.5%). Of the users, 16.7% (135/807) disagreed with the statement that the information they were looking for was easy to find. Approximately two-thirds (501/814, 61.5%) of users did not know whether it is easy to view in which pharmacies and health care units their prescription information has been viewed, and over one-third (306/805, 38.0%) did not know whether it is easy to view in which health care units their health information has been processed. Approximately one-fifth of participants (181/805, 22.5%) feared that unauthorized persons might view their information and that their electronically saved prescription and health information might disappear (180/810, 22.2%). In addition, 16.1% (129/799) expressed interest in receiving guidance on My Kanta use. The vast majority of users (719/804, 89.4%) were satisfied with the service overall. CONCLUSIONS Pharmacy customers were satisfied with the nationwide patient portal. It was mostly used for browsing e-prescriptions and medical records. Overall, the usability of the service was good. However, users need to be better informed about data privacy and security issues, and guidance on using the portal needs to be improved.

scholarly journals Effects of a Web-Based Patient Portal on Patient Satisfaction and Missed Appointment Rates: Survey Study

10.2196/17955 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e17955 ◽  
Author(s):  
Timothy A D Graham ◽  
Samina Ali ◽  
Melita Avdagovska ◽  
Mark Ballermann
Keyword(s):  
Health System ◽  
User Satisfaction ◽  
Clinic Visit ◽  
Survey Study ◽  
Relative Reduction ◽  
Patient Portal ◽  
Missed Appointments ◽  
Patient Portals ◽  
Appointment Attendance ◽  
System Use

Background Although electronic medical record (EMR)-tethered patient portals are common in other countries, they are still emerging in Canada. Objective We aimed to report user satisfaction and the effects of a patient portal on medical appointment attendance in a Canadian cohort of patients within our publicly funded health care system. Methods Two surveys were deployed, via email, at 2 weeks and 6 months following the first recorded patient portal access. Database audits of visit attendance were used to supplement and cross reference survey data. Results Between January 2016 and July 2018, 4296 patients accessed the patient portal. During the study, 28% (957/3421) consented patient portal users responded to one or more semistructured electronic surveys. Of respondents, 93% (891/957) reported that the patient portal was easy to use, 51% (492/975) reported it saved time when scheduling an appointment, and 40% (382/957) reported that they had to repeat themselves less during appointments. Respondents reported patient portal–related changes in health system use, with 48% (462/957) reporting avoiding a clinic visit and 2.7% (26/957) avoiding an emergency department visit. Across 19,968 visits in clinics where the patient portal was introduced, missed appointments were recorded in 9.5% (858/9021) of non–patient portal user visits, compared with 4.5% (493/9021) for patient portal users, representing a 53% relative reduction in no-show rates. Conclusions Early experience with an EMR-tethered patient portal showed strong reports of positive patient experience, a self-reported decrease in health system use, and a measured decrease in missed appointment rates. Implications on the expanded use of patient portals requires more quantitative and qualitative study in Canada.

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