scholarly journals Patterns in Patient Access and Utilization of Online Medical Records: Analysis of MyChart (Preprint)

2017 ◽  
Author(s):  
Donald A Redelmeier ◽  
Nicole C Kraus
Keyword(s):  
Trend Analysis ◽  
Time Trend ◽  
Medical Information ◽  
Patient Portal ◽  
Ice Storm ◽  
Patient Portals ◽  
Adverse Weather ◽  
Utilization Data ◽  
Study Interval ◽  
Over Time

BACKGROUND Electronic patient portals provide a new method for sharing personal medical information with individual patients. OBJECTIVE Our aim was to review utilization patterns of the largest online patient portal in Canada's largest city. METHODS We conducted a 4-year time-trend analysis of aggregated anonymous utilization data of the MyChart patient portal at Sunnybrook Health Sciences Centre in Ontario, Canada, from January 1, 2012, through December 31, 2015. Prespecified analyses examined trends related to day (weekend vs weekday), season (July vs January), year (2012 vs 2015), and an extreme adverse weather event (ice storm of December 20-26, 2013). Primary endpoints included three measures of patient portal activity: registrations, logins, and pageviews. RESULTS We identified 32,325 patients who registered for a MyChart account during the study interval. Time-trend analysis showed no sign of attenuating registrations over time. Logins were frequent, averaged 734 total per day, and showed an increasing trend over time. Pageviews mirrored logins, averaged about 3029 total per day, and equated to about 5 pageviews during the average login. The most popular pageviews were clinical notes, followed by laboratory results and medical imaging reports. All measures of patient activity were lower on weekends compared to weekdays (P<.001) yet showed no significant changes related to seasons or extreme weather. No major security breach, malware attack, or software failure occurred during the study. CONCLUSIONS Online patient portals can provide a popular and reliable system for distributing personal medical information to active patients and may merit consideration for hospitals.

Electronic Health Record Patient Portals and the Blockchain Technology

2021 ◽  
pp. 218-227
Author(s):  
Jorge Tavares
Keyword(s):  
Medical Information ◽  
Healthcare Providers ◽  
Appointment Scheduling ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Blockchain Technology ◽  
Electronic Health ◽  
Implementation Of Ehr ◽  
E Mail

The electronic health records (EHR) patient portals are an integrated eHealth technology that combines an EHR system and a patient portal, giving patients access to their medical records, exam results, and services, such as appointment scheduling, notification systems, and e-mail access to their physician. EHR patient portals empower patients to carry out self-management activities and facilitate communication with healthcare providers, enabling the patient and healthcare provider to access the medical information quickly. Worldwide governmental initiatives have aimed to promote the use of EHR patient portals. The implementation of EHR patient portals encompasses several challenges, including security, confidentiality concerns, and interoperability between systems. New technological approaches like blockchain could address these issues and enable a successful worldwide implementation of EHR patient portals.

scholarly journals Refilling medications through an online patient portal: consistent improvements in adherence across racial/ethnic groups

2015 ◽  
Vol 23 (e1) ◽  
pp. e28-e33 ◽  
Author(s):  
Courtney R. Lyles ◽  
Urmimala Sarkar ◽  
Dean Schillinger ◽  
James D. Ralston ◽  
Jill Y. Allen ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Health Behaviors ◽  
Ethnic Groups ◽  
Patient Portal ◽  
Patient Portals ◽  
Statin Adherence ◽  
Changes Over Time ◽  
Racial Ethnic ◽  
Over Time ◽  
Diabetes Patients

Abstract Objective Online patient portals are being widely implemented; however, no studies have examined whether portals influence health behaviors or outcomes similarly across patient racial/ethnic subgroups. We evaluated longitudinal changes in statin adherence to determine whether racial/ethnic minorities initiating use of the online refill function in patient portals had similar changes over time compared with Whites. Methods We examined a retrospective cohort of diabetes patients who were existing patient portal users. The primary exposure was initiating online refill use (either exclusively for all statin refills or occasionally for some refills), compared with using the portal for other tasks (eg, exchanging secure messages with providers). The primary outcome was change in statin adherence, measured as the percentage of time a patient was without a supply of statins. Adjusted generalized estimating equation models controlled for race/ethnicity as a primary interaction term. Results Fifty-eight percent of patient portal users were white, and all racial/ethnic minority groups had poorer baseline statin adherence compared with Whites. In adjusted difference-in-difference models, statin adherence improved significantly over time among patients who exclusively refilled prescriptions online, even after comparing changes over time with other portal users (4% absolute decrease in percentage of time without medication). This improvement was statistically similar across all racial/ethnic groups. Discussion Patient portals may encourage or improve key health behaviors, such as medication adherence, for engaged patients, but further research will likely be required to reduce underlying racial/ethnic differences in adherence. Conclusion In a well-controlled examination of diabetes patients’ behavior when using a new online feature for their healthcare management, patient portals were linked to better medication adherence across all racial/ethnic groups.

scholarly journals Mobile Access and Adoption of the Swedish National Patient Portal

2020 ◽  
Author(s):  
Maria Hägglund ◽  
Charlotte Blease ◽  
Isabella Scandurra
Keyword(s):  
Mobile Phone ◽  
Real World ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Real World Data ◽  
Mobile Access ◽  
National Patient ◽  
Administrative Tasks ◽  
Over Time

Patient portals are used as a means to facilitate communication, performing administrative tasks, or accessing one’s health record. In a retrospective analysis of real-world data from the Swedish National Patient Portal 1177.se, we describe the rate of adoption over time, as well as how patterns of device usage have changed over time. In Jan 2013, 53% of all visits were made from a computer, and 38% from a mobile phone. By June 2020, 77% of all visits were made from a mobile phone and only 20% from a computer. These results underline the importance of designing responsive patient portals that allow patients to use any device without losing functionality or usability.

scholarly journals Implications of Patient Portal Transparency in Oncology: Qualitative Interview Study on the Experiences of Patients, Oncologists, and Medical Informaticists (Preprint)

2017 ◽  
Author(s):  
Jordan M Alpert ◽  
Bonny B Morris ◽  
Maria D Thomson ◽  
Khalid Matin ◽  
Richard F Brown
Keyword(s):  
Health Knowledge ◽  
Medical Information ◽  
Patient Portal ◽  
Patient Portals ◽  
Face To Face ◽  
Advantages And Disadvantages ◽  
Communication Processes ◽  
Qualitative Interview Study ◽  
Unrestricted Access ◽  
Patient Provider Communication

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.

scholarly journals The State of Evidence in Patient Portals: Umbrella Review

10.2196/23851 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e23851
Author(s):  
Marcy G Antonio ◽  
Olga Petrovskaya ◽  
Francis Lau
Keyword(s):  
Knowledge Translation ◽  
Systematic Reviews ◽  
Business Models ◽  
Digital Health ◽  
Patient Portal ◽  
Umbrella Review ◽  
Patient Portals ◽  
Meta Level ◽  
Patient Reported ◽  
Over Time

Background Patient portals have emerged as a recognized digital health strategy. To date, research on patient portals has grown rapidly. However, there has been limited evaluation of the growing body of evidence on portal availability, use, clinical or health behavior and outcomes, and portal adoption over time. Objective This paper aims to comprehensively consolidate the current state of evidence on patient portals using the umbrella review methodology, introduce our approach for evaluating evidence for quantitative and qualitative findings presented in included systematic reviews, and present a knowledge translation tool that can be used to inform all stages of patient portal adoption. Methods For this study, a modified version of the Joanna Briggs Institute umbrella review method was used. Multiple databases were searched for systematic reviews focused on patient portals, and the final sample included 14 reviews. We conducted a meta-level synthesis of findings from quantitative, qualitative, and mixed methods primary studies reported in systematic reviews. We organized the umbrella review findings according to the Clinical Adoption Meta-Model (CAMM). Vote-counting, GRADE (Grading of Recommendations, Assessment, Development, and Evaluations), and CERQual (Confidence in the Evidence from Review of Qualitative Research) were used to assess the umbrella review evidence. Results Our knowledge translation tool summarizes the findings in the form of an evidence map. Organized by the CAMM categories, the map describes the following factors that influence portal adoption and effects over time: patient contexts, patient's interest and satisfaction, portal design, facilitators and barriers, providers' attitudes, service utilization, behavioral effects, clinical outcomes, and patient-reported outcomes. The map lists the theories and mechanisms recognized in the included portal research while identifying the need for business models and organizational theories that can inform all stages of portal adoption. Our GRADE and CERQual umbrella review evaluation resulted in the majority of evidence being rated as moderate to low, which reflects methodological issues in portal research, insufficient number of studies, or mixed results in specific focus areas. The 2 findings with a high rating of evidence were patients' interest in using portals for communication and the importance of a simple display of information in the portals. Over 40 portal features were identified in the umbrella review, with communication through secure messaging and appointment booking mentioned in all systematic reviews. Conclusions Our umbrella review provides a meta-level synthesis to make sense of the evidence on patient portals from published systematic reviews. Unsystematic and variable reporting of portal features undermines the ability to evaluate and compare portal effects and overlooks the specific context of portal use. Research designs sensitive to the social, organizational, policy, and temporal dimensions are needed to better understand the underlying mechanisms and context that leverage the identified factors to improve portal use and effects.

scholarly journals A Novel Digital Platform Approach to Enhance Enterprise-Wide Patient Portal Adoption (Preprint)

2018 ◽  
Author(s):  
Yauheni Solad ◽  
Shrawan Patel ◽  
Allen Hsiao ◽  
Ashish Atreja
Keyword(s):  
Medical Information ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Portal ◽  
New Haven ◽  
Patient Portals ◽  
Digital Platform ◽  
Care Plans ◽  
Number Of Patients ◽  
Haven Hospital

BACKGROUND Patient portals provide a simplified route for health providers to share medical information with individual patients, and are incentivized under Meaningful Use. Currently there are numerous friction factors in the onboarding process of patient portals that limits patients signing up for them. As a result, health systems are spending significant resources to drive the adoption of patient portals, with limited success. OBJECTIVE To evaluate the effectiveness of a innovative rules-driven digital patient engagement strategy for patients to sign up for online patient portal at an academic medical center. METHODS Rx.Universe is a digital platform integrated into provider EMR systems that enables physicians to directly “prescribe” mobile health applications and/or digital care bundles to patients. Rx.Universe Bulk Prescription feature was used to prescribe—via SMS—a direct link to the MyChart login page with the patient’s unique code and personal information embedded within the link. This removed several key barriers to adoption: patients needing to copy and paste access codes, fill in their personal data and complete this process within 30 days—after which their unique access code expires. The Rx.Universe engagement dashboard displayed the total number of patients who received prescribed messages, the number of unsuccessful prescriptions, prescriptions opened in the first 24 hours, and total prescriptions opened. RESULTS We digitally prescribed MyChart Activation to 23,485 patients under the care of Yale-New Haven Hospital over a period of 2 days. Of these prescriptions, 21,997 (93.66%) were successfully delivered and 1488 (6.33%) failed to be delivered because of incorrect cell phone numbers in EHR. Of the prescriptions successfully prescribed, 2170 (9.86%) were clicked within 24 hours of being prescribed with a total of 2378 (10.81%) clicked within a week. CONCLUSIONS Digital Medicine Platforms offer new channel for onboarding and following up patients through customized digital care plans. The power of this approach in removing barriers for patients is highlighted by the fact that Yale-New Haven Hospital met their yearly MyChart adoption target through this campaign within a week. Furthermore, the data could be assessed and acted upon in real-time as opposed to the usual weeks. This technology can be extended to close the care gaps for hospitals and Accountable Care Organizations (ACO) in a scalable manner for a subpopulation, with manual processes reserved for patients unable to be reached in an automated fashion.

scholarly journals The State of Evidence in Patient Portals: Umbrella Review (Preprint)

2020 ◽  
Author(s):  
Marcy G Antonio ◽  
Olga Petrovskaya ◽  
Francis Lau
Keyword(s):  
Knowledge Translation ◽  
Systematic Reviews ◽  
Business Models ◽  
Digital Health ◽  
Patient Portal ◽  
Umbrella Review ◽  
Patient Portals ◽  
Meta Level ◽  
Patient Reported ◽  
Over Time

BACKGROUND Patient portals have emerged as a recognized digital health strategy. To date, research on patient portals has grown rapidly. However, there has been limited evaluation of the growing body of evidence on portal availability, use, clinical or health behavior and outcomes, and portal adoption over time. OBJECTIVE This paper aims to comprehensively consolidate the current state of evidence on patient portals using the umbrella review methodology, introduce our approach for evaluating evidence for quantitative and qualitative findings presented in included systematic reviews, and present a knowledge translation tool that can be used to inform all stages of patient portal adoption. METHODS For this study, a modified version of the Joanna Briggs Institute umbrella review method was used. Multiple databases were searched for systematic reviews focused on patient portals, and the final sample included 14 reviews. We conducted a meta-level synthesis of findings from quantitative, qualitative, and mixed methods primary studies reported in systematic reviews. We organized the umbrella review findings according to the Clinical Adoption Meta-Model (CAMM). Vote-counting, GRADE (Grading of Recommendations, Assessment, Development, and Evaluations), and CERQual (Confidence in the Evidence from Review of Qualitative Research) were used to assess the umbrella review evidence. RESULTS Our knowledge translation tool summarizes the findings in the form of an evidence map. Organized by the CAMM categories, the map describes the following factors that influence portal adoption and effects over time: patient contexts, patient's interest and satisfaction, portal design, facilitators and barriers, providers' attitudes, service utilization, behavioral effects, clinical outcomes, and patient-reported outcomes. The map lists the theories and mechanisms recognized in the included portal research while identifying the need for business models and organizational theories that can inform all stages of portal adoption. Our GRADE and CERQual umbrella review evaluation resulted in the majority of evidence being rated as moderate to low, which reflects methodological issues in portal research, insufficient number of studies, or mixed results in specific focus areas. The 2 findings with a high rating of evidence were patients' interest in using portals for communication and the importance of a simple display of information in the portals. Over 40 portal features were identified in the umbrella review, with communication through secure messaging and appointment booking mentioned in all systematic reviews. CONCLUSIONS Our umbrella review provides a meta-level synthesis to make sense of the evidence on patient portals from published systematic reviews. Unsystematic and variable reporting of portal features undermines the ability to evaluate and compare portal effects and overlooks the specific context of portal use. Research designs sensitive to the social, organizational, policy, and temporal dimensions are needed to better understand the underlying mechanisms and context that leverage the identified factors to improve portal use and effects.

scholarly journals Older adults using a patient portal: registration and experiences, one year after implementation

2018 ◽  
Vol 4 ◽  
pp. 205520761879788 ◽  
Author(s):  
Gaby Anne Wildenbos ◽  
Karim Maasri ◽  
Monique Jaspers ◽  
Linda Peute
Keyword(s):  
Older Adults ◽  
Medical History ◽  
Older Adult ◽  
Medical Information ◽  
Data Extraction ◽  
Adult Patients ◽  
Patient Portal ◽  
Patient Portals ◽  
History Information ◽  
One Year

Background and objectives The interest of older adults in using patient portals is rising, yet subject to functional and usability barriers. This study aims to gain insight into registration rates and experiences of older adult patients using a patient portal, one year after implementation in an academic hospital. Methods Registration rates for one year were collected via automated data extraction. Older adult patients’ experiences were collected through a survey, available via the portal in the last three months of the year. Results Older adults were a large user group of the patient portal and appreciated its functionalities. In one year, 10,679 older adult patients (aged 56+) registered, which constituted 47% of total portal registrations. The 131 older adult survey respondents had a mean age of 64.5 years and 40% indicated that they liked to review their medical information and appointments via the portal. Yet, older adults experienced user interaction issues and had higher expectations of content within the portal and patient/provider communication through the portal. Of the survey respondents, 22% experienced usability issues at login and in viewing test results, 15% commented on late or no responses by providers on patients’ sent messages and 24% expected the portal to provide medical history information. Implications: Patient portal designs should be optimized to usability needs of older adults. Portals preferably include medical history information, physicians’ notes and require prompt responses of providers.

Racial Resentment and Attitudes Toward the Use of Force by Police: An Over-Time Trend Analysis

2016 ◽  
Vol 86 (4) ◽  
pp. 492-511 ◽  
Author(s):  
J. Scott Carter ◽  
Mamadi Corra
Keyword(s):  
Trend Analysis ◽  
Time Trend ◽  
Use Of Force ◽  
Racial Resentment ◽  
Over Time

scholarly journals Insights Into Older Adult Patient Concerns Around the Caregiver Proxy Portal Use: Qualitative Interview Study (Preprint)

2018 ◽  
Author(s):  
Celine Latulipe ◽  
Sara A. Quandt ◽  
Kathryn Altizer Melius ◽  
Alain Bertoni ◽  
David P. Miller Jr ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Older Adult ◽  
Medical Information ◽  
Personal Information ◽  
Comfort Level ◽  
Adult Patients ◽  
Patient Portal ◽  
Patient Portals ◽  
Qualitative Interview Study

BACKGROUND Electronic patient portals have become common and offer many potential benefits for patients’ self-management of health care. These benefits could be especially important for older adult patients dealing with significant chronic illness, many of whom have caregivers, such as a spouse, adult child, or other family member or friend, who help with health care management. Patient portals commonly contain large amounts of personal information, including diagnoses, health histories, medications, specialist appointments, lab results, and billing and insurance information. Some health care systems provide proxy accounts for caregivers to access a portal on behalf of a patient. It is not well known how much and in what way caregivers are using patient portals on behalf of patients and whether patients see any information disclosure risks associated with such access. OBJECTIVE The objective of this study was to examine how older adult patients perceive the benefits and risks of proxy patient portal access by their caregivers. METHODS We conducted semistructured interviews with 10 older adult patients with chronic illness. We asked them about their relationship with their caregivers, their use of their patient portal, their caregiver’s use of the portal, and their perceptions about the benefits and risks of their caregiver’s use of the portals. We also asked them about their comfort level with caregivers having access to information about a hypothetical diagnosis of a stigmatized condition. Two investigators conducted a thematic analysis of the qualitative data. RESULTS All patients identified caregivers. Some had given caregivers access to their portals, in all cases by sharing log-in credentials, rather than by setting up an official proxy account. Patients generally saw benefits in their caregivers having access to the information and functions provided by the portal. Patients generally reported that they would be uncomfortable with caregivers learning of stigmatized conditions and also with caregivers (except spouses) accessing financial billing information. CONCLUSIONS Patients share their electronic patient portal credentials with caregivers to receive the benefits of those caregivers having access to important medical information but are unaware of all the information those caregivers can access. Better portal design could alleviate these unwanted information disclosures.

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