8 hours ago Background: Patient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear. Objective: The aim of this systematic review was to summarize evidence on the impact of patient portals on health … >> Go To The Portal
Also, patient portals can be adapted to the patient’s wishes and knowledge level [23]. They can also be completed by secure communication links with health care providers or other functions. Overall, we could expect a higher impact of online portals compared to paper-based access.
This study contributes to a more nuanced understanding of super users, whose role had previously only been discussed in a positive light, by highlighting that super users behave in ways that can positively and negatively affect implementation.
Concerning emergency room (ER) visits, a decreasing trend was described [54,60], and active portal users showed more outpatient and inpatient visits and fewer ER visits per month, compared with patients without an account [28]. The number of visits over 6 months for asthmatic patients was lower among users than among nonusers (3 vs 9) [60].
In either case, just three words can summarize the potential value-added of patient portals to consumers: ease of communications, fast solutions and efficient chronic disease management — but only if the portals are actually integrated into patients’ lives.
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.
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.
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.
Engaging patients in the delivery of health care has the potential to improve health outcomes and patient satisfaction. Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication.
About seven in 10 individuals cited their preference to speak with their health care provider directly as a reason for not using their patient portal within the past year. About one-quarter of individuals who did not view their patient portal within the past year reported concerns about privacy and security..
Sharing credentials can lead to multiple data security and privacy problems, including revealing more information than the patient intended, and to health care practitioner confusion and mistakes if they do not know with whom they are communicating.
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.
Unfortunately, what makes your patient portal valuable for patients is exactly what makes it attractive to cybercriminals. It's a one-stop shop for entire health records, and identity thieves can make a fast buck from stealing this data and selling it on.
Patient rostering facilitates clear commitments from both family physicians and their patients. It enables proactive care opportunities by identifying patients and their clinical problems, thus facilitating the development of care plans.
Here are some ways to encourage patient enrollment:Include information about the patient portal on your organization's website.Provide patients with an enrollment link before the initial visit to create a new account.Encourage team members to mention the patient portal when patients call to schedule appointments.More items...•
Further, portals help providers educate their patients and prepare them for future care encounters. When patients have access to their health data, they are better informed, and have the potential to generate deep and meaningful conversations regarding patient wellness during doctor's appointments.
Patient portals facilitate patient engagement in healthcare decisions, improve communication, and streamline care. Less than one-third of patients access patient portals to view their medical data. Nurses can improve patient portal use by explaining the benefits and providing education.
The main goal of improving the accuracy of patient identification is broken into two sub-goals: using at least two patient identifiers when providing care, treatment and services, and eliminating transfusion errors related to patient misidentification.
A patient has the right to refuse any drugs, treatment or procedures to the extent permitted by law after hearing the medical consequences of refusing the drug, treatment or procedure. A patient has the right to have help getting another doctor's opinion at his or her request and expense.
These principles are autonomy, beneficence, non-maleficence, and justice. Each of these principles has a unique objective, but the four come together to empower you as a health care professional and ensure that patients are receiving high quality and ethical health care.
Anticoagulation therapy poses risks to patients and often leads to adverse drug events due to complex dosing, requisite follow-up monitoring, and inconsistent [patient] compliance.
The researchers observed that when super users were more engaged (ie, proactive, provided more comprehensive explanations for their actions, used positive framing, and shared information more freely), they became more effective in helping to improve their co-workers' proficiency in using the EHR system.
Four super user behaviours differed between the two units: proactivity, depth of explanation, framing, and information-sharing. The unit in which super users were more proactive, provided more comprehensive explanations for their actions, used positive framing, and shared information more freely experienced significantly greater improvement in clinicians’
The authors assessed super users’ behaviours by observing 29 clinicians and conducting 24 in-depth interviews. The implementation outcome, clinicians’ information systems (IS) proficiency, was assessed using longitudinal survey data collected from 43 clinicians before and after the EHR start date. Multivariable linear regression was used to estimate the relationship between clinicians’ IS proficiency and the clinical unit in which they worked.
Electronic health records (EHRs) are designed to improve patient safety and quality of care, but the intended benefits of EHRs are not always realised because of implementation-related challenges.
When patients cannot communicate in real time, providers can miss opportunities to identify nonadherence. Thus, there is heavy focus on designing portals and apps similar to MyMeds, which incorporates bidirectional communication between providers and patients.
mHealth could affect specialty pharmacies in several ways. Specialty pharmacies manage patients with rare and chronic diseases that require high-cost and complex medications; thus, it is important to have adequate clinical support. Some patient portals and apps include adherence notifications, adverse effect mitigation strategies, and clinical management of disease and therapy. With secure e-mail messaging through patient portals, patients can quickly report adverse effects or dose adjustments, which may be beneficial when the physician’s office is closed.
For instance, a patient who wants to increase medication adherence can use apps such as PatientPartner, Medisafe, Dosecast, MedHelper, My Pillbox, or MyMeds. While the variation in mHealth apps caters to patient preferences, the lack of standardization leads to drawbacks for providers. For example, many of these apps either track data differently or, in many cases, do not relay information back to the provider. Patients may record their missed doses through these apps—while refilling their medications on time. This may portray to providers that their patients adhere to their medication even when they do not. When patients cannot communicate in real time, providers can miss opportunities to identify nonadherence. Thus, there is heavy focus on designing portals and apps similar to MyMeds, which incorporates bidirectional communication between providers and patients.
As patient portals and mHealth apps evolve , incorporation of technology in specialty pharmacies presents an excellent opportunity for improving patient care. Ultimately, mHealth technology allows patients to play a role in managing their health and is another form of communication with providers that can lead to better patient outcomes.
Many patient portals are mobile enabled via a web-based platform and are therefore considered a form of mHealth. Patient-focused mHealth apps—software or programs stored directly on the mobile device—can provide an opportunity for patient-initiated health or disease management.
Table 2 gives the findings of the multivariable analyses, in which 8003 practices were classified as health IT super-users (26.6%). The odds of super-user status were lower for single-specialty, multispecialty, and allied health practices than for primary/family care clinics, and lower still for practices providing specialist services or acute care. The likelihood of super-use increased as the number of affiliated physicians increased, and super-users were more than twice as likely to be located in metropolitan areas than rural. Overall, the odds of being a super-user were highest for practices in the Midwest.
In contrast, 11,706 practices (38.9%) were classified as health IT under-users. Under-user practices were more likely to be situated in the West, have fewer affiliated physicians, and be located outside of metropolitan centers. Compared with primary/family care practices, single-specialty, multispecialty, and allied health practices were more likely to be under-users, as were those that provided specialist or acute care services. Figure 1, Figure 2, and Figure 3 give the geographical location of super- and under-users and the proportion of these practices by county.
This study has some limitations. First, we used 2014 reported data, and practices may have since expanded their health IT functionality. However, changes since this time are likely to be incremental only; given that we have focused on the “outliers” of EHR use, it is unlikely that there would be substantial alterations in the proportions of either super- or under-users. Second, this is the first publication using HIMSS ambulatory care data, and their validity has not been examined by the research community. However, many published studies have used the HIMSS hospital dataset, 15-17 which utilizes the same sampling and survey methodology as the ambulatory practice survey that provided the data in our study. One such study describes this source as the “industry standard for information on EMR [electronic medical record] adoption.” 18 Accordingly, a strength of our study is its presentation of the first-ever analysis of the corresponding data from HIMSS about ambulatory care health IT use. The HIMSS survey represents one of the most comprehensive assessments of use of health IT that currently exists; our study extended the current taxonomy of EHR systems well beyond that of “basic” and “comprehensive.” Finally, the survey includes only ambulatory practices that are affiliated with a health system. Given a presumed desire for system interoperability, we might expect greater use of some health IT functionalities (such as health information exchange) by the ambulatory practices in our sample compared with independent practices. The use of this subset, in conjunction with our focus on those practices with a preexisting operational EHR, suggests that our results may overestimate the true proportion of super-users in the broader ambulatory care setting and that the national rate is even lower; the reverse is also likely true for the estimates of under-users.
HIMSS conducts annual surveys of US health systems and organizations, with a particular focus on structural characteristics of their EHR and health IT functionalities in use, generating a comprehensive database that has been frequently used in empirical research. 15-18 To date, published studies that have employed these data utilized only the data regarding hospitals. 19 However, HIMSS also obtains data on ambulatory care practices, defined as facilities providing “preventative, diagnostic, therapeutic, surgical, and/or rehabilitative outpatient care where the duration of treatment is less than 24 hours—and is generally referred to as outpatient care.” We used data from the 2014 ambulatory practice survey, which contains information on more than 75% of US health system—associated ambulatory care practices. HIMSS defines a health system as an organization composed of at least 1 hospital and its associated nonacute facilities, and “associated” as a governance relationship (ie, they are owned, leased, or managed by a health system). Eligible practices for our study were those that indicated they had a “live and operational” EHR and had completed at least 1 health IT functionality survey question. We linked the practice site zip code with a publicly available dataset providing a geographic taxonomy to develop a measure of rurality. 20
The 7 domains were data repository, clinical decision support, order entry management, electronic messaging, results management, health information exchange, and patient use . The HIMSS survey asks respondents to indicate if they use any of more than 50 EHR-based health IT functionalities and, in some cases, assesses the intensity of this use (eg, “What proportion of orders are completed using the EHR?”). We matched all of these items to 1 of the 7 domains of functionality (details are given in the eAppendix [ available at ajmc.com ]).
The EHR acts as a backbone for a range of health information technology (IT) functionalities with multiple potential applications to care delivery; practices vary in their adoption of these functionalities and in the extent of their use of these tools in routine practice.
Methods: We created a novel framework for classifying ambulatory care practices employing 7 domains of health IT functionality. Drawing from the survey responses, we created a composite “use” variable indicating the extent of health IT functionality use across these domains. “Super-user” practices were defined as having near-full employment of the 7 domains of health IT functionalities and “under-users” as those with minimal or no use of health IT functionalities. We used multivariable logistic regression to investigate how the odds of super-use and under-use varied by practice size, type, urban or rural location, and geographic region.
They found that it is particularly persuasive when providers encourage patients to use the portal because patients trust providers and value their opinions. One provider says he reinforces a patient’s use of the portal by closing all messages with “Thanks for using the portal.”.
One major challenge with the portal is the multiple step registration process . Patients provide their e‐mail address at the front desk and are given a password to register from home. Some patients fail to complete the registration process after leaving the clinic. Remembering and managing passwords and managing family accounts are also challenging for patients. For example, a parent may log in for one child and then ask questions about a second child. For providers and staff, a challenge is that there is no way to know whether a Web‐enabled patient actually uses the portal and there are no read receipts to confirm that patients have read a message.
Messaging is monitored periodically to ensure that communication with patients is succinct and user-friendly.
PHMG launched the patient portal in early 2010. As a first step, the physician champion piloted the portal for about 6 months before it was implemented in one clinic at a time. According to the physician champion, implementation was “easier than expected because everyone was already comfortable with eClinicalWorks, ...
Providers want to hear from other providers about new technologies. Physician champions can share practical how‐to information and address their colleagues’ questions and concerns from the physician perspective . Teaming physician and administrative champions can be an effective approach to introducing new technologies and processes.
Messages are in patients’ own words and not subject to others interpretation, biases, or attention to detail
Expand Portal Access. PHMG also plans to expand portal access to urgent care patients who do not have a regular provider.
Similarly, healthcare providers can achieve at least three big benefits from patients’ portal-usage: greater efficiencies, cost-savings and improved health outcomes — again, only if patients use their portals. But with only 20% of patients regularly relying on portals, many benefits have been unattainable. Why are most portals realizing so little of their promise?
Similarly, healthcare providers can achieve at least three big benefits from patients’ portal-usage: greater efficiencies, cost-savings and improved health outcomes — again, only if patients use their portals. But with only 20% of patients regularly relying on portals, many benefits have been unattainable.
Multi-disciplinary internal support and interaction across a variety of departments especially clinical functions is essential. Communication experts with content, usability and marketing experience, working with clinicians and office staff who understand healthcare and revenue workflows, are needed to deploy portals that work well both for patients and providers. Despite the industry’s continuing lack of systems interoperability, dramatic portal improvements and greater benefits are possible now.
By definition, a new communications model that gives patients the front row privilege of taking greater charge of their own healthcare may seem to physicians and hospitals as a move into a back row. A new communications model to many patients may seem complicated and unnecessary, especially when they have no obligation to use it.
A big issue for many users is that portals are simply too complicated for at least two opposite kinds of users: those who have low computer literacy, and those who are so computer savvy that they expect the simplicity of an Uber or Instagram app to get a test result or appointment with a click or two.
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The centerpiece of Meaningful Use / MIPS requirements was the EHR. Implementing a patient portal was indeed a necessary component, but just one. If the chosen EHR included a patient portal, which most did, it was a no-brainer for providers to implement its basic components, often with a poorly defined plan for adding modules when MU deadlines were no longer looming. Since then, other priorities often have taken precedence, but whatever the reasons, many portals in use today are not meeting users’ needs.