10 hours ago · Benefits, barriers, and impact of patient portals and mHealth applications. Mobile health (mHealth) is a means of providing health services or information via portals or applications (apps) on wireless devices, such as smartphones or tablets. Patient portals are secure websites that help patients access their health information at their convenience. >> Go To The Portal
Benefits, barriers, and impact of patient portals and mHealth applications
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Open in a separate window Innovation: Patient Portal Barriers Lack of perceived usefulness, lack of accessibility, and guaranteeing privacy and securitywere identified as barriers for portal implementation.
Patient portals may have a range of functionalities that enable information exchange (such as having access to the EHR), which in turn may facilitate and improve the communication between the patient and the health care professional [11,14].
In addition, the portal only provides information for one health care institution, so patients do not have a complete overview of their health information. Facilitators Perceived usefulness, attractiveness, perceived ease of use, and participation of end usersduring implementation were seen as facilitators for implementation.
Of patient portal benefits and challenges, however, probably the biggest concern is the security of a patient’s sensitive medical data. Your office cannot simply set up a free website and expect patients to allow their medical data to be posted there! But good news: patient portals are safe.
What are the Top Pros and Cons of Adopting Patient Portals?Pro: Better communication with chronically ill patients.Con: Healthcare data security concerns.Pro: More complete and accurate patient information.Con: Difficult patient buy-in.Pro: Increased patient ownership of their own care.
The truth is, there are a lot of benefits to using a patient portal for providers.Better Patient Communication. ... Streamline Patient Registration and Administrative Tasks. ... Greater Focus on Patient Care. ... Better Patient-Physician Relationships. ... Improve Clinical Outcomes. ... Optimize Medical Office Workflow.
Even though they should improve communication, there are also disadvantages to patient portals....Table of ContentsGetting Patients to Opt-In.Security Concerns.User Confusion.Alienation and Health Disparities.Extra Work for the Provider.Conclusion.
Burying lab results or not offering access to clinician notes will likely keep patients from seeing the utility of the portal. Even if providers offer this health data, making it difficult for patients to navigate to it will reduce the utility in the technology.
The patient portal supports two-way communication, which allows the patient to work with physicians between patient visits, request appointments, and receive reminders. These reminders can be for appointments, need for follow-up, and more.
4 Pros and Cons of Digital Patient Health Data AccessPro: Patients enjoy digital data access.Con: Complicated health info causes concern for patients, docs.Pro: Patients can review info for medical errors.Con: Clinician notes raise patient-provider relationship concerns.
The reason why most patients do not want to use their patient portal is because they see no value in it, they are just not interested. The portals do not properly incentivize the patient either intellectually (providing enough data to prove useful) or financially.
One con to keep in mind with patient portals is that some patients may not have much experience with computers, preventing them from getting the most out of it. Another drawback is the potential for data breaches, so you'll need to work with a vendor that provides robust, secure EHR software.
Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes.
Four of those factors positively affect patients' intention to use: internet access, perceived usefulness, facilitating conditions, and internet use. On the other hand, there was no effect of three factors on intention to use: ethnicity, sex, and health status.
There are numerous potential benefits to PHRs, including improved patient-provider relationships, increased patient empowerment, and enhanced care safety, efficiency, coordination, and quality. However, privacy, security, cost, and adoption issues have been significant barriers to implementation.
Sixty-three percent reported not using a portal during the prior year. In multivariable analysis, we found that nonusers were more likely to be male, be on Medicaid, lack a regular provider, and have less than a college education, compared to users.
In total, we selected 376 quotes and identified 26 barriers and 28 facilitators. The results are presented according to the 6 levels of the Grol and Wensing model [26]. The full list of all barriers and facilitators—including the number of subjects for each stakeholder group—is presented in Multimedia Appendix 3. After the inclusion of 7 hospitals (using purposive sampling), we analyzed the data saturation. The data were found to be saturated, meaning that after analyzing the first 6 hospitals, no new categories emerged from the transcripts of the final hospital. We therefore did not include further hospitals.
This can be affected by multiple factors at the micro (eg, “individuals”), meso (eg, “re sources”), and macro (eg, “sociopolitical context”) levels [21]. Several implementation models are available, such as “The Consolidated Framework for Implementation Research (CFIR),” which is used in many studies as a guiding framework [22-24]. CFIR consists of 5 levels at which barriers and facilitators can occur during implementation: (1) technology-related factors (eg, “adaptability,” “complexity,” and “cost”); (2) outer setting (eg, “policy and incentives”); (3) inner setting (eg, “resources”); (4) process (eg, “engagement of stakeholders”); and (5) individual health professionals (eg, “individual’s knowledge”). In this model, patients are part of the “outer setting,” suggesting that the CFIR framework is aimed primarily at institutions [24]. Another example is the “Fit between Individuals, Tasks, and Technology” (FITT) framework, which is aimed at the adoption of IT [25]. The comprehensive model of Grol and Wensing [26] summarizes the barriers to and facilitators of change in health care practice at 6 levels: (1) innovation; (2) individual professional; (3) patient; (4) social context; (5) organizational context; and (6) economic and political context. McGinn et al [21] argue that the consideration of various stakeholder opinions can contribute to successful implementations. However, previous research mainly focused on perceptions of single stakeholder groups regarding patient portal implementation, such as physicians [27] or nurses [28]. This highlights the importance of identifying the opinions of many stakeholders during patient portal implementation. Furthermore, it remains unclear which factors are important in accomplishing change in the various groups [26].
All interviews were performed by telephone and lasted for, on average, 20 min. Participants were first asked for their consent to make audio recordings of the interviews. Then, the purpose of the interview was introduced, and subjects were asked if they received the introductory email. This email was then briefly discussed such that the subjects were aware of the topics to be discussed. After that, questions were asked about participants’ characteristics, such as their age and work experience. To make sure an unambiguous definition of a patient portal was used, participants were asked what their definition of a patient portal was, and if necessary, it was complemented with our definition. Then, we asked them about their perceived barriers to and facilitators of patient portal implementation at all 6 levels [26]. If necessary, for example, if the question was unclear, the interviewer provided examples (and these were also sent per email). At the end of the interview, the participants were asked to suggest additional topics or issues, if any, that had not yet been covered. The interviews were in Dutch, and the questions in Multimedia Appendix 1are translations.
Patient-centeredness is an important element of high-quality care: effective communication between patients and their health care professionals , and information access can both contribute considerably to this [1]. According to the Institute of Medicine, “patients should have unfettered access to their own medical information” [2] to support them in taking control of their health (eg, using medical information to make informed health-related decisions) [2]. Information technology (IT) can play an important role in improving access to this information [3], and it also improves the participation of patients in their own care [4]. In health care, an increasingly popular way to facilitate this is by using patient portals [5]. Patient portals can be defined as “applications which are designed to give the patient secure access to health information and allow secure methods for communication and information sharing” [6], as well as for administrative purposes [7], and are mostly provided by a single health care institution [6,8]. These portals are often connected to the electronic health record (EHR) of an institution—defined as tethered patient portals [9]—to provide access to patients’ medical information [3,10-12]. Some institutions allow patient portals to facilitate communication between patients and health care professionals [3,6,12], view their appointments and provide patient education [11,13], share information [12], request for repeat medication prescriptions [3], and provide tailored feedback [11,13]. Patient portals may have a range of functionalities that enable information exchange (such as having access to the EHR), which in turn may facilitate and improve the communication between the patient and the health care professional [11,14]. Previous research showed that patients are especially satisfied with access to information from the EHR and the list of their appointments [11]. Portal use can also have a positive effect on self-management of conditions [15-18], communication between patients and providers, quality of care [16,17] and participation in treatment [17]. Patient empowerment can also be improved; the accessibility of information can especially contribute to “patients’ knowledge” and their “perception of autonomy and being respected” [19]. On the other hand, effects on health outcomes are reported to be mixed [6]. In summary, patient portals can be important as they provide patients with access to their own medical information, enable interaction with their health care professionals [8], and aim to involve patients in their own care processes [1].
Patient portal implementation is a complex process and is not only a technical process but also affects the organization and its staff. Barriers and facilitators occurred at various levels and differed among hospital types (eg, lack of accessibility) and stakeholder groups (eg, sufficient resources) in terms of several factors. Our findings underscore the importance of involving multiple stakeholders in portal implementations. We identified a set of barriers and facilitators that are likely to be useful in making strategic and efficient implementation plans.
The basic function of a patient portal is to engage patients in their own care, educating them on not only their personal health but also assisting them to take control of their treatment options.
Of patient portal benefits and challenges, however, probably the biggest concern is the security of a patient’s sensitive medical data. Your office cannot simply set up a free website and expect patients to allow their medical data to be posted there!
5. They improve data accuracy. Because patients have access to their medical records, it is easy for them to spot inaccurate information and bring it to their provider’s attention. 6.
Meaningful use standards provide minimal criteria for securing and delivering electronic health records. Although the term “meaningful use” is now outdated, the ideas behind the term are not. According to the U.S. Centers for Disease Control and Prevention, the goal of meaningful use standards are as follows: 1 Improve quality, safety, efficiency, and reduce health disparities 2 Increase patient engagement 3 Improve care coordination 4 Expand population and public health 5 Ensure adequate privacy and security protection for personal health information
HIPAA privacy rules offer protections that grow with children. Parents have full access to their child’s account up to a certain age, at which point teens take control of their own health, often through a portal that makes this automatic.
Once a patient creates a secure login, they have access to many of the things they need to manage their healthcare.
If your practice is in a rural area , or if many of your patients have limited mobility , video conferencing and messaging allows patients to experience the same quality of care.
Direct patient access to electronic medical records offers a host of benefits and few drawbacks. Continuing to refine usability, personalization, and comprehension will ensure increased access to diverse patient groups.
A number of factors influence patient adoption of such a system, including race and ethnicity, age, and socioeconomic status. 3 Noting previous findings that racial and ethnic minority patients access their healthcare information online compared to non-Hispanic white patients, a qualitative study published in October 2016 by researchers at the University of California, San Francisco, investigated reasons for this difference. 4 They conducted focus groups with patients who were part of a large healthcare system that had adopted portal use more than a decade earlier.
5,6 The authors suggest that more widespread use in diverse patient groups may require more user-friendly and personalized portals.
Nearly gone are the days when one had to wait for a phone call to learn test results, or go through several steps to reach the physician’s office staff only to confirm basic details of their medical history or care. Instead, they can simply log on to a secure site and see for themselves. A number of recent studies have explored ...
Direct patient access to EHR confers multiple benefits, though disparities in access should be addressed.
The Promoting Interoperability Program incentivized health care providers to demonstrate meaningful use of EHRs through progressive demonstration of core objectives. Specifically, eligible professionals and hospitals must give patients the ability to “view online, download, and transmit their health information and hospital admission information” to meet meaningful use objectives for adoption and use of EHRs. 15, 16 However, literature has largely focused on the architecture of EHRs, facilitators of and barriers to adoption by hospitals and clinicians, and privacy and security concerns. 8 Patient studies have focused on perceptions of the utility and adoption of PPs, 17 PPs access and use in specific settings, 18, 19 and/or among specific patient populations. 19 ⇓⇓⇓– 23
Gender, education, marital status, and having a regular clinician were factors associated with access, facilitators of use, and use of PPs ( Table 2 ). Age, language proficiency, and having health insurance were also associated with PPs access and use but not race and ethnicity.
The stem question for PPs content knowledge was: “Do any of your online medical records include 1) laboratory test results, 2) current list of medications, 3) a list of health/medical problems, 4) an allergy list, 5) summaries of your office visits, 6) clinical notes, and 7) an immunization or vaccination history” [1 = yes, 0 = no / do not know]. The stem question for PPs function use was: “In the past 12 months, have you used your online medical record to 1) make appointments with a health care provider; 2) request refill of medications; 3) fill out forms or paperwork related to your health care; 4) request correction of inaccurate information; 5) securely message health care provider and staff (eg, email); 6) look up test results; 7) monitor your health; 8) download your health information to your computer or mobile device such as a cell phone or tablet; 9) add health information to share with your health care provider such as health concerns, symptoms, and side effects; and 10) help you make a decision about how to treat an illness or condition” [1 = yes, 0 = no].
Background: Patient access to their medical records through patient portals (PPs) facilitates information exchange and provision of quality health care. Understanding factors that characterize patients with limited access to and use of PPs is needed.
Lack of confidence in security of electronic records and the less frequent use of some PP functions (eg, monitor health) highlight the necessity of examining PP utility to patients in enhancing communication with clinicians and promoting trust, managing chronic disease–related decisions, and facilitating lifestyle behavioral change among patients with the highest needs. 2 Research should gauge patients’ preferences for procedural factors in using PPs, 53, 54 their perceptions of PP usability, and track their actual PPs use online by socioeconomic status, race/ethnicity, and health literacy. 55, 56
Data on gender, age, race/ethnicity, income, education, employment, marital status, place of birth, English language proficiency, having health insurance and a regular provider, and general health were collected. Internet use, means to access the Internet, and mobile device ownership were collected. Census region and rural-urban classification were provided.
Mobile for All. https://mobileforall.org/. Accessed Feb. 4, 2019.