nursing informatics: empowering consumers through the patient portal

What is Informatics and why does it matter in nursing?

Informatics offers a platform where health care providers interact with patients for improved health outcomes. The process takes five steps. In the first step, patients have to interact with the portals through the Internet, access information in step …

What is health informatics?

May 20, 2016 · Consumer Health Informatics (CHI) is a rapidly growing domain within the field of biomedical and health informatics. The objective of this paper is to reflect on the past twenty five years and showcase informatics concepts and applications that led to new models of care and patient empowerment, and to predict future trends and challenges for the next 25 years.

What is a nurse informatics specialist?

Apr 11, 2019 · Patient portals can provide secure, online access to personal health information [ 1] such as medication lists, laboratory results, immunizations, allergies, and discharge information [ 2 ]. They can also enable patient-provider communication using secure messaging, appointments and payment management, and prescription refill requests [ 2, 3 ].

Do patient requests for nonclinical information and functions affect portal development?

The patient portal movement has been spurred by arguments such as the information savvy patient who represents a well- informed consumer and seeks better medical attention through knowledge and ability to discern quality facilities / professionals.

How does consumer health informatics relate to patient portals?

Consumer health informatics examines patient information from points of view such as health literacy, consumer knowledge, and education. The goal is to empower patients while giving them the knowledge they need to make their own health decisions.Feb 15, 2017

How does nursing informatics improve patient care?

How Nursing Informatics Improves Patient CareAligning Nursing Best Practice with Clinical Workflows and Care. ... Improving Clinical Policies, Protocols, Processes, and Procedures. ... Providing Training and Learning Based on Objective Data. ... Selecting and Testing New Medical Devices. ... Reducing Medical Errors and Costs.More items...•Jan 23, 2019

How do patient portals improve patient engagement?

Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication.

What is the nurse's role in implementation of patient portals in healthcare?

Nurses see the portal as an additional service for patients, because it offers them the possibility for asking questions at any time and place suitable for the patient. Some nurses experience an increase in work load, because patients ask more non-urgent questions that otherwise would not be asked.Jun 15, 2012

Why is nursing informatics important in healthcare?

NI promotes the generation, manage- ment and processing of relevant data in order to use information and develop knowledge that supports nursing in all practice domains.

What is the role of nursing informatics in healthcare?

Nurse Informaticists play a crucial role in evaluating healthcare data and identifying areas of opportunity within the clinical settings for improvement. Their primary focus is to look for ways to reduce the strain on nursing and management teams while also increasing patient care and satisfaction.Aug 6, 2020

What is the advantage of a patient portal for the patient?

The Benefits of a Patient Portal You can access all of your personal health information from all of your providers in one place. If you have a team of providers, or see specialists regularly, they can all post results and reminders in a portal. Providers can see what other treatments and advice you are getting.Aug 13, 2020

How effective are patient portals?

Improve Clinical Outcomes Patient portals make tasks such as requesting prescription refills and referrals easier and more convenient leads to greater patient compliance – and when patients follow doctors' orders, clinical outcomes improve.Dec 8, 2017

What are the benefits and challenges of using patient portals?

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.Feb 17, 2016

Is a patient portal an EHR?

Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients.

How does informatics improve health care?

Informatics improves the coordination of this information , allowing nurses to give their patients all of the information they need, improving both outcomes and the satisfaction with care . While there are some who criticize the use of informatics and technology to help manage care, arguing that it makes health care more impersonal, ...

Why is health informatics important?

Health informatics provides important data that can prevent these errors; for example, an electronic record can provide information about a possible dangerous medication interaction or allergy that might not otherwise be immediately apparent. Armed with data, nurses can make quick decisions that keep their patients safe.

Why is patient safety important in nursing?

Patient safety is a primary concern of any health care provider, and nurses are often on the front lines of ensuring that their patients are kept safe and preventing medication errors, misdiagnoses, falls, and other problems.

What is nursing care?

Modern nursing care is driven by individual patient needs and history — information that is collected and organized in electronic patient records. By documenting a patient’s condition, and sharing that information electronically, nurses are able to more effectively manage care, and by extension, improve the quality of that care.

What is the role of a nurse in a patient's care?

Nurses are often called upon to help coordinate the care of their patients. This often means relaying information from physicians, therapists, pharmacy, billing, and more, both during care and at discharge. Without all of the necessary information, patient care could suffer.

Is nursing a high tech profession?

Nursing is increasingly becoming as “high tech” as it is a “high touch” profession. Today’s nurses have more technology at their disposal than any nurses ever before, and as one might expect, it’s considerably improving patient care.

Why are patient portals important?

Patient portals are designed to be tools to more fully engage patients in their health care and help enable them to better manage their own health information. As the U.S. health care system rapidly adopted electronic health records (EHRs) over the past decade, many with linked patient portals, enthusiasm and expectations for this new technology as a means to engage and empower patients grew. Most patient portals have a set of core features designed to facilitate health care transactions, information tracking, and communication with care team members. The evidence supporting the anticipated benefits of patient portals on patient outcomes, however, remains mixed and incomplete. Moreover, a paradox exists in that, despite a high consumer interest in patient portals, widespread adoption remains relatively low. Potential reasons include the need for greater provider endorsement, examination and adaptation of clinical workflows, and the recognition of patient engagement as a reciprocal process.

What is health information technology?

Health information technology is a core infrastructure for the chronic care model, integrated care, and other organized care delivery models. From the provider perspective, health information exchange (HIE) helps aggregate and share information about a patient or population from several sources. HIE technologies include direct messages, transfer of care, and event notification services. From the patient perspective, personal health records, secure messaging, text messages, and other mHealth applications may coordinate patients and providers. Patient-reported outcomes and social media technologies enable patients to share health information with many stakeholders, including providers, caregivers, and other patients. An information architecture that integrates personal health record and mHealth applications, with HIEs that combine the electronic health records of multiple healthcare systems will create a rich, dynamic ecosystem for patient collaboration.

How does an infomediary help in healthcare?

Online health infomediaries are emerging as a critical element in the healthcare sector to support and influence individuals’ health and wellness decisions. The business success and effectiveness of health infomediaries depend on the active and sustained engagement of patients. Although the growth in the number of participants in an infomediary is expected to add value by increasing the diversity of information that is potentially exchanged, the infomediary cannot survive without the sustained engagement of existing users. The challenge is to understand the underlying processes at the operational workflow level of an infomediary that can lead to sustained engagement of patients. For an infomediary to increase engagement, it needs to know not only what motivates participants to join an infomediary but also what keeps them engaged in various stages of participation or transitions. In this study, we employ a Markov Chain modeling approach, along with an analysis of the user activities data, to understand the underlying mechanism of patient engagement along with several transition states in an online health infomediary. We tracked 127,610 members, with more than 1 million activities involved in an online health infomediary that supports cosmetic and reconstructive surgery patients over one year. Patients’ decisions for cosmetic and reconstructive surgery are health and well‐being choices that rely not only on patients’ current situation but also on the knowledge and experience of others. This relevance of the health infomediary context is explored in this study. We sampled the activities of 32,505 active users’ activities with data on more than 500,000 activities. We analyzed the dynamics of user behaviors by modeling longitudinal transition probabilities across different states of participation. Additional analyses and robustness checks, using text‐mined data from the users’ activities, are introduced to gain nuanced insights into user engagement. Our study provides several practical implications for the design and management of an online health infomediary.

What is the most common sexually transmitted infection?

Background Human Papillomavirus (HPV) leads to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. Furthermore, providers recommend the HPV vaccine less than half the time for eligible patients. Prior informatics research has demonstrated the effectiveness of computer-based clinical decision support (CDS) in changing provider behavior, especially in the area of preventative services. Methods Following a randomized clinical trial to test the effect of a CDS intervention on HPV vaccination rates, we conducted semi-structured interviews with health care providers to understand whether they noticed the CDS reminders and why providers did or did not respond to the prompts. Eighteen providers, a mix of medical doctors and nurse practitioners, were interviewed from five publicly-funded, urban health clinics. Interview data were qualitatively analyzed by two independent researchers using inductive content analysis. ResultsWhile most providers recalled seeing the CDS reminders, few of them perceived the intervention as effective in changing their behavior. Providers stated many reasons for why they did not perceive a change in their behavior, yet the results of the trial showed HPV vaccination rates increased as a result of the intervention. ConclusionsCDS reminders may be effective at changing provider behavior even if providers perceive them to be of little use. Trial registrationClinicalTrials.gov Identifier: NCT02551887Registered on September 15, 2015

What is patient portal?

Patient portals linked to electronic health records are recognized as a promising multifaceted tool to help achieve patient engagement goals. Achieving significant growth in adoption and use requires agile evaluation methods to complement periodic formal research efforts.

What is event notification?

Event notification is a form of health information exchange (HIE) which has the potential to support care coordination by alerting primary care providers when a patient experiences an acute care event. While promising, there exists little evidence on the impact of event notification in support of reengagement into primary care. The objectives of this study are to 1) examine the effectiveness of event notification on health outcomes for older adults who experience acute care events, and 2) compare approaches to how providers respond to event notifications. Methods: In a cluster randomized trial conducted across two medical centers within the U.S. Veterans Health Administration (VHA) system, we plan to enroll older patients (≥ 65 years of age) who utilize both VHA and non-VHA providers. Patients will be enrolled into one of three arms: 1) usual care; 2) event notifications only; or 3) event notifications plus a care transitions intervention. In the event notification arms, following a non-VHA acute care encounter, an HIE-based intervention will send an event notification to VHA providers. Patients in the event notification plus care transitions arm will also receive 30 days of care transition support from a social worker. The primary outcome measure is 90-day readmission rate. Secondary outcomes will be high risk medication discrepancies as well as care transitions processes within the VHA health system. Qualitative assessments of the intervention will inform VHA system-wide implementation. Discussion: While HIE has been evaluated in other contexts, little evidence exists on HIE-enabled event notification interventions. Furthermore, this trial offers the opportunity to examine the use of event notifications that trigger a care transitions intervention to further support coordination of care. Trial registration: ClinicalTrials.gov NCT02689076. "Regional Data Exchange to Improve Care for Veterans After Non-VA Hospitalization." Registered 23 February 2016.

What is personalized care planning?

Background Personalized care planning is a patient-centered, whole-person approach to treatment planning. Personalized care plans improve patient outcomes and are now mandated for chronic care management reimbursement. Yet guidance on how to best implement personalized care planning in practice is limited. Objective We examined the adoption of personalized care planning in patient-centered medical home (PCMH) clinics to identify processes and organizational characteristics that facilitated or hindered use in routine practice. Design Qualitative multiple-case study design. We conducted site visits at PCMH clinics in four US Veterans Health Administration (VHA) medical centers. Data included 10 general clinic observations, 34 direct observations of patient-provider clinical encounters, 60 key informant interviews, and a document review. Data were analyzed via qualitative content analysis using a priori and emergent coding. Participants Employees and patients participating in clinical encounters in PCMH clinics at four VHA medical centers. Key Results Each clinic used a distinct approach to personalized care planning: (1) distributed tasks approach; (2) two-tiered approach; (3) health coaching approach; and (4) leveraging a village approach. Each varied in workflow, healthcare team utilization, and degree of integration into clinical care. Across sites, critical components for implementation included expanding planning beyond initial assessment of patient priorities; framing the initiative for patients; using a team-based approach to care plan development and updates; using communication mechanisms beyond the electronic health record; and engaging stakeholders in implementation planning. Conclusions Personalized care planning is a novel patient-centered practice, but complicated to implement. We found variation in effective implementation and identified critical components to structuring this practice in a manner that engages patients in treatment aligned with personal priorities. Primary care practices seeking to implement personalized care planning must go beyond simply asking patients a series of questions to establish a plan. They must also engage team members in plan development, communication, and dissemination.

Abstract

Technological advances, coupled with a shift toward patient-centered care and unprecedented consumer access to information, have created a new era of consumer engagement, empowerment, and activation.

About this chapter

Nazi K.M., Hogan T.P., Woods S.S., Simon S.R., Ralston J.D. (2016) Consumer Health Informatics: Engaging and Empowering Patients and Families. In: Finnell J., Dixon B. (eds) Clinical Informatics Study Guide. Springer, Cham. https://doi.org/10.1007/978-3-319-22753-5_19

Why is data important in nursing?

Data can improve accuracy and guide clinical best practice, but changes also bring new challenges for team members. A nurse informaticist provides information about new workflows, guides new technology and process implementation, and assesses data quality , giving care teams the best chance of optimal care delivery.

What is a CNIO?

The CNIO serves as a bridge between nursing and information technology and partners with the Chief Medical Information Officer, who serves as a bridge between the medical community and information technology—together, the CNIO and CMIO focus on information, data, and communication.

What is the role of a nurse informatics?

Nurse informaticists have three essential responsibilities that help the nursing workforce document and submit accurate data and leverage it to develop evidence-based procedures for optimal care delivery.

What is data science in healthcare?

As healthcare focuses more on data science-centric processes to improve patient care, such as machine learning and artificial intelligence, technology adoption and communication between clinical teams and IT resources (e.g., the EHR or an ancillary system) are paramount.

What is an EHR implementation?

Any type of new electronic implementation (e.g., an EHR or patient portal) means a change in the clinical process. The clinical team will evaluate and adapt current processes in the context of the new technology and then implement it. With greater data access, health systems can identify additional care gaps and improvement opportunities, making a nurse informaticist’s role in new process education and implementation even more critical.

What is patient engagement?

An important area of discussion is the use of patient portals or web portals and its relation to patient engagement. The term “patient engagement” is commonly used but often poorly understood in healthcare. Therefore, for this discussion, patient engagement is defined as the patient’s capability and willingness to actively decide to participate in their healthcare and collaborate with a healthcare facility or provider for the goal of improvement in care or positive outcomes (Higgins et al., 2017). Providers can promote patient engagement through health information technology (HIT) by using practical and appealing designs to maximize patient involvement (Higgins et al., 2017; Schnall et al., 2016).

How was the portal feedback form used?

Portal activity was monitored, and the portal feedback form was used to guide any necessary changes that should be made either to the portal or to the program to assist in project sustainability. Data was collected and analyzed by the team leader and team members, including the clinic lead for eClinicalWorks and Healow portal system. The number of registered patients with verification via eClinicalWorks were collected and compared to the number of registered patients prior to the initiative. AHRQ feedback forms and PHE-5 scales were collected and counted to assess for patient engagement and portal feedback. Pre and post-PHE-5 scales were collected and given to a third-party statistician to assess for patient engagement. The overarching aim of increasing patient engagement by 60% of participating patients was measured via the PHE-5 scores and information collected from portal analytics. Additional factors, such as no-show rates, portal analytics, and MU metrics were collected and given to clinic administrators and providers.

What is PDSA in healthcare?

A Plan Do Study Act (PDSA) model was used as the framework for this study due to its allowance for continuous improvement and flexibility, including promotion of project sustainability (Donnelly & Kirk, 2015). Additionally, the Empowerment Informatics Framework was chosen to guide the integration of patient-empowering technology (Knight & Shea, 2014). Empowering patients with health- enabling technologies to increase self-management and patient-defined goals is the outcome of the portal initiative program (Francis, 2017).

What is patient portal?

Background: Patient portals are an effective way of engaging patients to become active participants in their health; however, getting patients to actively use portals in the outpatient setting is challenging.

How did the Patient Portal initiative work?

Implementation of the patient portal initiative was found to be successful in increasing registration and adoption of the patient portal by participants. Patients reported increased knowledge of conditions and increased satisfaction with being able to see laboratory results and communicate more effectively with their providers. Marketing portal availability via clinic staff, providers, and posters was effective in increasing participation. Although no monetary or physical incentives were offered for this study, future studies could implement incentives, such as gift card promotions, to increase patient enrollment. The use of a portal leader to assist patients in setting up the portal application on their phones and demonstrating its use was a factor in the increasing portal registration numbers.

What is the PHE-5 scale?

The PHE-5 scale is a Likert scale that helps to measure patient engagement Graffigna et al., 2017). It consists of five ordinal items that ask participants how they feel when they think about their disease. The PHE-5 scale investigates “engagement” by evaluating multiple levels of the patients’ perception of their health (Graffigna et al., 2015). The PHE-5 scale was completed at the beginning of each patient education encounter and was given as a post-test after project completion to participants via follow up phone calls during the last two weeks of the portal program.

How often is the HIMSS journal published?

Powered by the HIMSS Foundation and the HIMSS Nursing Informatics Community, the Online Journal of Nursing Informatics is a free, international, peer reviewed publication that is published three times a year and supports all functional areas of nursing informatics.

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• Modern nursing care is driven by individual patient needs and history information that is collected and organized in electronic patient records. By documenting a patients condition, and sharing that information electronically, nurses are able to more effectively manage care, and by extension, improve the quality of that care.

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