scholarly journals Defining Empowerment and Supporting Engagement Using Patient Views From the Citizen Health Information Portal: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Tracie Risling ◽  
Juan Martinez ◽  
Jeremy Young ◽  
Nancy Thorp-Froslie
Keyword(s):  
Qualitative Methodology ◽  
Digital Health ◽  
Patient Empowerment ◽  
Primary Objective ◽  
Patient Portal ◽  
Interpretive Description ◽  
Patient Portals ◽  
Information Portal ◽  
Use Of Technology ◽  
Self Reported Health Status

BACKGROUND The increasing presence of technology in health care has created new opportunities for patient engagement and with this, an intensified exploration of patient empowerment within the digital health context. While the use of technology, such as patient portals, has been positively received, a clear linkage between digital health solutions, patient empowerment, and health outcomes remains elusive. OBJECTIVE The primary objective of this research was to explore the views of participants enrolled in an electronic health record portal access trial regarding the resultant influence of this technology on their feelings of patient empowerment. METHODS The exploration of patient empowerment within a digital health context was done with participants in a tethered patient portal trial using interpretive description. Interpretive description is a qualitative methodology developed to pragmatically address clinical health questions. Patient demographics, self-reported health status, and self-identified technology adaptation contributed to the assessment of empowerment in this qualitative approach. RESULTS This research produced a view of patient empowerment within the digital health context summarized in two overarching categories: (1) Being Heard and (2) Moving Forward. In each of these, two subcategories further delineate the aspects of empowerment, as viewed by these participants: Knowing More and Seeing What They See under Being Heard, and Owning Future Steps and Promoting Future Care under Moving Forward. This work also highlighted an ongoing interconnectedness between the concepts of patient empowerment, engagement, and activation and the need to further articulate the unique aspects of each of these. CONCLUSIONS The results of this study contribute needed patient voice to the ongoing evolution of the concept of patient empowerment. In order to move toward more concrete and accurate measure of patient empowerment and engagement in digital health, there must be further consideration of what patients themselves identify as essential aspects of these complex concepts. This research has revealed relational and informational elements as two key areas of focus in the ongoing evolution of patient empowerment operationalization and measure.

scholarly journals What can we learn from second generation digital natives? A qualitative study of undergraduates’ views of digital health at one London university

2018 ◽  
Vol 4 ◽  
pp. 205520761878815 ◽  
Author(s):  
Aasha E Cowey ◽  
Henry W W Potts
Keyword(s):  
Thematic Analysis ◽  
Second Generation ◽  
Digital Health ◽  
National Policy ◽  
Digital Natives ◽  
Generation Gap ◽  
Patient Portals ◽  
Individual Interviews ◽  
Use Of Technology ◽  
Health And Fitness

Objectives We live in a digital age and opportunities within healthcare are increasing, ranging from patient portals to wearable devices. Today’s undergraduates are second generation digital natives and are at a critical point of becoming more autonomous in their healthcare interactions. This study aims to understand their experiences of both digital and broader healthcare. This will enable a better understanding of implications for national policy, individual healthcare organisations and further research. Methods Undergraduates aged 18–21 participated in individual interviews or focus groups. Inductive thematic analysis was undertaken. Negative member checking and feedback on emerging themes from both participants and experts were used to increase the validity of the study. Results Twenty-four undergraduates participated in the study, including a high proportion of international students. Thematic analysis revealed 16 themes. Six key themes explored in this paper are: generation gap; impact on healthcare professionals (HCPs); use of technology to replace or enhance HCP interactions; use of technology to support administration/transactional activities; paper vs electronic; and personally held health and fitness data. Conclusion This paper highlights recommendations for the undergraduate cohort and wider populations including better articulation of benefits, making digital options more personalised and interactive, and raising awareness of dangerous ‘obsessive’ behaviour around health and fitness apps. Some of our findings challenge the assumption that this generation will automatically accept digital initiatives, including the importance this cohort continues to place on face-to-face interactions. In response, we offer some suggestions to improve awareness, utilisation and acceptance of digital health.

OP140 Adult Patient Access To Electronic Health Records

2019 ◽  
Vol 35 (S1) ◽  
pp. 32-32
Author(s):  
Petra Schnell-Inderst ◽  
Stefanie Neyer ◽  
Alexander Hörbst ◽  
Gerhard Müller ◽  
Uwe Siebert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cochrane Review ◽  
Patient Empowerment ◽  
Significant Risk ◽  
Study Groups ◽  
Composite Score ◽  
Patient Portal ◽  
Patient Portals ◽  
Health Related ◽  
Electronic Health

IntroductionIn order to facilitate patient information, patient involvement, and to support patient-centered care, healthcare organizations are increasingly offering access to patient data that are stored in the institution-specific electronic health record (EHR). Patients can access these data, read, and print them, or download and integrate them into any type of patient-held record. This EHR access is typically web-based and called “patient portal” allowing the independent access via the Internet from everywhere. A patient portal may also offer additional features such as prescription requests, appointment booking, messaging, personal health-related reminders, individual therapeutic recommendations, personal diaries, and social networking with other patients. In a Cochrane review, we assessed the effects of providing access to EHR for adult patients on patient empowerment and health-related outcomes compared to usual care.MethodsAccording to the methods of evidence-based medicine, we developed a protocol for a Cochrane review, which is published in the Cochrane database.ResultsWe identified ten randomized controlled trials (RCTs) including 6,668 randomized participants. Seven RCTs took place in the USA, two in Canada, and one in Japan. Additional functionalities of interventions and disease conditions were heterogeneous. Three studies (n = 601) reported on patient empowerment. The risk differences reported were neither statistically significant nor clinically relevant. Eight studies (n = 2,070) reported on nine different risk factors (blood pressure, blood glucose, poor asthma control, 10-year Framingham risk score, cholesterol, body mass index, composite score of eight variables, intraocular pressure, composite score of three variables). The results were heterogeneous. Mostly there were no statistically significant risk differences between study groups.ConclusionsOverall, there is no evidence for a clear positive effect of patient portals on patient empowerment and health related outcomes (mainly risk factors). However, we identified only a small number of studies. The usage of portals was often low and several studies were older.

Patient Portal Acceptance by the Elderly

2020 ◽  
pp. 67-90
Author(s):  
Karoly Bozan ◽  
Kevin R. Parker ◽  
Bill Davey
Keyword(s):  
Older People ◽  
Technology Acceptance ◽  
Social Power ◽  
Least Squares Method ◽  
The Elderly ◽  
Cognitive Effort ◽  
Patient Portal ◽  
Patient Portals ◽  
Use Of Technology ◽  
Likelihood Model

The motivating factors that influence patient portal acceptance among the elderly are not well understood. Using the social heuristic theory, the elaboration likelihood model, and the unified theory of acceptance and use of technology, this study proposes a model that examines the persuasive mechanisms for the elderly to use patient portals. An empirical study involving 117 subjects in the United States was used to test the proposed model. Using the partial least squares method, social power, and imitate-the-successful social heuristics were found to significantly influence patient portal acceptance among the elderly. These findings indicate that older people invest less effort cognitively elaborating when presented with technology acceptance decisions and accept influence from their higher status peers from their network. Imitate-the-majority heuristics and central route processing were not found to be significant, implying that older people are more inclined to take advice from sources, which they find credible and invest less cognitive effort in evaluating the complex phenomena.

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 Feasibility of an Interactive Patient Portal for Monitoring Physical Activity, Remote Symptom Reporting, and Patient Education in Oncology: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Michael Marthick ◽  
Anna Janssen ◽  
Birinder S Cheema ◽  
Jennifer Alison ◽  
Tim Shaw ◽  
...  
Keyword(s):  
Physical Activity ◽  
Digital Health ◽  
Symptom Reporting ◽  
Patient Portal ◽  
Semistructured Interview ◽  
Web Portal ◽  
Patient Portals ◽  
Web Based ◽  
Qualitative Thematic Analysis ◽  
The Web

BACKGROUND Digital health interventions, such as the use of patient portals, have been shown to offer benefits to a range of patients including those with a diagnosis of cancer. OBJECTIVE This study aimed to explore the participant experience and perception of using an interactive Web-based portal for monitoring physical activity, remote symptom reporting, and delivering educational components. METHODS Participants who were currently under treatment or had recently completed intensive treatment for cancer were recruited to three cohorts and invited to join a Web-based portal to enhance their physical activity. Cohort 1 received Web portal access and an activity monitor; cohort 2 had additional summative messaging; and cohort 3 had additional personalized health coaching messaging. Following the 10-week intervention, participants were invited to participate in a semistructured interview. Interview recordings were transcribed and evaluated using qualitative thematic analysis. RESULTS A total of 17 semistructured interviews were carried out. Participants indicated that using the Web portal was feasible. Personalized messaging improved participant perceptions of the value of the intervention. There was a contrast between cohorts and levels of engagement with increasing health professional contact leading to an increase in engagement. Educational material needs to be tailored to the participants’ cancer treatment status, health literacy, and background. CONCLUSIONS Participants reported an overall positive experience using the Web portal and that personalized messaging positively impacted on their health behaviors. Future studies should focus more on design of interventions, ensuring appropriate tailoring of information and personalization of behavioral support messaging.

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 Feasibility of an Interactive Patient Portal for Monitoring Physical Activity, Remote Symptom Reporting, and Patient Education in Oncology: Qualitative Study

JMIR Cancer ◽  
10.2196/15539 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e15539 ◽  
Author(s):  
Michael Marthick ◽  
Anna Janssen ◽  
Birinder S Cheema ◽  
Jennifer Alison ◽  
Tim Shaw ◽  
...  
Keyword(s):  
Physical Activity ◽  
Digital Health ◽  
Symptom Reporting ◽  
Patient Portal ◽  
Semistructured Interview ◽  
Web Portal ◽  
Patient Portals ◽  
Web Based ◽  
Qualitative Thematic Analysis ◽  
The Web

Background Digital health interventions, such as the use of patient portals, have been shown to offer benefits to a range of patients including those with a diagnosis of cancer. Objective This study aimed to explore the participant experience and perception of using an interactive Web-based portal for monitoring physical activity, remote symptom reporting, and delivering educational components. Methods Participants who were currently under treatment or had recently completed intensive treatment for cancer were recruited to three cohorts and invited to join a Web-based portal to enhance their physical activity. Cohort 1 received Web portal access and an activity monitor; cohort 2 had additional summative messaging; and cohort 3 had additional personalized health coaching messaging. Following the 10-week intervention, participants were invited to participate in a semistructured interview. Interview recordings were transcribed and evaluated using qualitative thematic analysis. Results A total of 17 semistructured interviews were carried out. Participants indicated that using the Web portal was feasible. Personalized messaging improved participant perceptions of the value of the intervention. There was a contrast between cohorts and levels of engagement with increasing health professional contact leading to an increase in engagement. Educational material needs to be tailored to the participants’ cancer treatment status, health literacy, and background. Conclusions Participants reported an overall positive experience using the Web portal and that personalized messaging positively impacted on their health behaviors. Future studies should focus more on design of interventions, ensuring appropriate tailoring of information and personalization of behavioral support messaging. International Registered Report Identifier (IRRID) RR2-10.2196/9586

scholarly journals Maximizing Opportunities for User-Centered Design in Acute-Care: Introducing the Focal Wall

2021 ◽  
Author(s):  
Tracie Risling ◽  
Krista Baerg ◽  
Susan Tupper ◽  
Lori Chartier
Keyword(s):  
Acute Care ◽  
Collaborative Design ◽  
Digital Health ◽  
Primary Objective ◽  
User Centered Design ◽  
Patient Portals ◽  
Patient Centered ◽  
Centered Care ◽  
Technological Developments ◽  
User Centered

Digital health is a promising development in the pursuit of patient centered care. Technological developments, like patient portals, are providing new opportunities for patients to engage in their own healthcare journeys, increasing access to health data and practitioners in many cases. The primary objective of this research is the establishment of an in-patient portal for a new children’s hospital through a collaborative design process. This paper details experiences from the first phase of this multi-year project and in particular methodological solutions that have been developed in order to meet the challenges of engaging acute care patients, families, and practitioners in user-centered design within such a demanding context.

scholarly journals Factors That Influence Use of a Patient Portal by Health Professionals

2021 ◽  
Vol 18 (4) ◽  
pp. 1877
Author(s):  
Anna Janssen ◽  
Melanie Keep ◽  
Hiran Selvadurai ◽  
Andrea Kench ◽  
Sharon Hunt ◽  
...  
Keyword(s):  
Health Professionals ◽  
Healthcare Team ◽  
Patient Portal ◽  
Structured Interviews ◽  
Patient Portals ◽  
Implementation Support ◽  
Healthcare Teams ◽  
Barriers And Enablers ◽  
Paediatric Care ◽  
Use Of Technology

Patient portals are websites or apps that provide patients with tools to manage healthcare appointments, access their health records, and communicate with clinicians. Patient portals have been demonstrated to be beneficial for improving communication between patients/carers and their healthcare team in a range of health settings. However, there is limited research on the barriers and enablers for implementing patient portals from the perspective of health professionals and healthcare teams, particularly in a paediatric setting. This study aimed to understand healthcare teams’ experiences of using a patient portal and, using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, explore the barriers and enablers to ongoing use. Participants were 11 health professionals participating in the pilot of a patient portal for patients/carers in paediatric care. Data were collected using semi-structured interviews. Analysis of the interview data identified nine themes about implementing a patient portal in paediatric care, all of which aligned with the four constructs of the UTAUT. This study identified that barriers and enablers of the uptake of a patient portal by health professionals in a paediatric context aligned with the UTAUT framework. Value for the patient, improved workflow, and adequate technical and implementation support were highlighted by participants.

scholarly journals Estimating Patient Empowerment and Nurses’ Use of Digital Strategies: eSurvey Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9844
Author(s):  
Olga Navarro Martínez ◽  
Jorge Igual García ◽  
Vicente Traver Salcedo
Keyword(s):  
Digital Literacy ◽  
Digital Health ◽  
Quality Care ◽  
Patient Empowerment ◽  
Health Centers ◽  
Digital Resources ◽  
Additional Information ◽  
Digital World ◽  
Use Of Technology ◽  
The One

Patient empowerment is seen as the capability to understand health information and make decisions based on it. It is a competence that can improve self-care, adherence and overall health. The COVID-19 pandemic has increased the need for information and has also reduced the number of visits to health centers. Nurses have had to adapt in order to continue offering quality care in different environments such as the digital world, but this entails assessing the level of their patients’ empowerment and adapting material and educational messages to new realities. The aim of this study is, on the one hand, to assess nurses’ use of digital resources to provide reinforcing information to their patients and, on the other hand, to evaluate how they assess the level of empowerment of their patients. To perform the study, 850 nurses answered 21 questions related to their own digital literacy and patients’ empowerment. The ability to make decisions is the characteristic most selected by nurses (70%) as useful in measuring patient empowerment, whereas 9.19% do not measure it in any way. Printed material is most often used by nurses to offer additional information to patients (71.93%), mobile applications are the least used option (21.58%), and elder nurses are those who most recommend digital resources. In this study, younger nurses make little or no use of technology as a resource for training and monitoring patients. In spite of some limitations concerning the study, digital health needs to be promoted as an indisputable tool in the nurse’s briefcase in the future to ensure that older patients can manage electronic resources in different fields.

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