13 hours ago Oct 16, 2017 · One looked at health literacy by focusing on numeracy , another used eHEALS , and another measured health literacy by the number of questions that were asked about the content in the patient portal . More research is needed to measure this barrier using a uniform method to identify how it affects portal use for older adults and to find design or implementation … >> Go To The Portal
Oct 16, 2017 · One looked at health literacy by focusing on numeracy , another used eHEALS , and another measured health literacy by the number of questions that were asked about the content in the patient portal . More research is needed to measure this barrier using a uniform method to identify how it affects portal use for older adults and to find design or implementation …
Jun 23, 2015 · Health care delivery factors, mainly provider endorsement and patient portal usability, also contribute to patients’ ability to engage through and with the patient portal. While health literacy has been identified as an important factor in the successful use of patient portals, few studies have used validated health literacy measures, making ...
Methods: We reviewed literature from 2006 through 2014 in PubMed, Ovid Medline, and PsycInfo using the search terms "patient portal" OR "personal health record" OR "electronic personal health record". Final inclusion criterion dictated that studies report on the patient experience and/or ways that patients may be supported to make competent ...
Mar 30, 2017 · Health care organizations should consider the following strategies to align people, process, and technology in order to meet the needs of the older adults they serve: (1) create a patient portal adoption campaign tailored to the needs of older adult so that the benefits are communicated in a contextually relevant way, (2) offer task-specific training so they feel they …
Over the past few decades, there has been a significant proliferation in the implementation and use of electronic health records (EHRs) creating vast opportunities for improvement in the efficiency and quality of patient care as well as reduction in healthcare costs. 1 Driven by a multitude of social and economic factors, most notably financially-overstretched healthcare systems and patients’ wishes for a more active role in the management of their disease, patient portals are increasingly being seen as powerful tools for health promotion. A patient portal is often tethered to the EHR of the hospital and most portals offer the same set of basic functions to patients, such as a secure means to schedule appointments, view laboratory results, request medication prescriptions and send secure messages to a healthcare team. 2 – 4 Older adults, aged 50 years and above, typically need healthcare services related to multi and comorbidity problems and for this reason can benefit in particular from the use of a portal. Access to their medical record content and interaction with their providers via a portal can support them specifically in maintaining wellness and independence during the management of their medical condition (s). 5
Twenty-two respondents (17%) had explicit comments on communication with the medical staff, with 19 (15%) of them indicating a negative experience. Physicians’ unresponsiveness to respondents’ messages sent via MyChart was a clear source of dissatisfaction: ‘Not every doctor looks at the record and it sometimes takes days or even longer before a message is answered or sometimes there is no answer at all’ (female, 73).
Prof. Dr MWJ is head of the research laboratory of Human Factors and Usability Studies at the Department of Medical Informatics at the Academic Medical Center of Amsterdam, where this research took place. Dr LP is an expert in Human Factor methods in Health Informatics. GW is a PhD student and expert in Human Factor methods for mobile devices. KM is a Master Medical Informatics student and Medical Doctor. Study conception was created by MWJ, LP and GW; design was created by LP and GW. Acquisition of data was performed by GW. Analysis and interpretation of data was performed by KM, GW and LP. Drafting of manuscript was performed by GW, KM and LP was involved in writing the manuscript from the first version onwards. MWJ was further involved in critical revision of the manuscript.
The MyChart web support team created an online survey in Dutch with open-ended questions (Online Appendix A). Patients could provide compliments and/or suggestions on main functionalities of MyChart, including the registration and login process, the messaging feature and viewing/editing of medical information. The survey served to gain insight in how MyChart’s functionalities could be improved. The management team of MyChart in the AMC set the survey’s requirements: it had to be non-obtrusive regarding a patient’s regular MyChart use, thus short in length and not excessively present or marketed while a patient used MyChart. A patient communication advisor and two eHealth specialists of the AMC pre-tested and approved the survey. Consent by patients for scientific research was included in the terms and conditions of MyChart and this study was approved by the Medical Ethical Committee of the AMC.
This study was approved by the Medical Ethical Committee of the Academic Medical Center in Amsterdam. Consent by patients for scientific research was included in the terms and conditions of ‘ Mijn Dossier ’ of the Academic Medical Center in Amsterdam.
The Clinical Adoption Framework (CAF) has been developed to analyze EHR adoption, but this framework does not consider the patient as an end-user. Objective We aim to extend the scope of the CAF to patient access to EHRs, develop guidance documentation for the application of the CAF , and assess the interrater reliability . Methods We systematically reviewed existing systematic reviews on patients' access to EHRs and PHRs. Results of each review were mapped to one of the 43 CAF categories. Categories were iteratively adapted when needed. We measured the interrater reliability with Cohen’s unweighted kappa and statistics regarding the agreement among reviewers on mapping quotes of the reviews to different CAF categories. Results We further defined the framework’s inclusion and exclusion criteria for 33 of the 43 CAF categories and achieved a moderate agreement among the raters, which varied between categories. Conclusions In the reviews, categories about people, organization, system quality, system use, and the net benefits of system use were addressed more often than those about international and regional information and communication technology infrastructures, standards, politics, incentive programs, and social trends. Categories that were addressed less might have been underdefined in this study. The guidance documentation we developed can be applied to systematic literature reviews and implementation studies, patient and informal caregiver access to EHRs, and the adoption of PHRs.
Background: A personal health record (PHR) system encourages patients to engage with their own health care by giving them the ability to manage and keep track of their own health data. Of the numerous PHR systems available in the market, many are Web-based patient portals and a few are mobile apps. They have mainly been created by hospitals and electronic health record (EHR) vendors. One major limitation of these hospital-created PHR systems is that patients can only view specific health data extracted from their EHR. Patients do not have the freedom to add important personal health data they collect in their daily lives into their PHR. Therefore, there is an information gap between clinical visits. Objective: The aim of this study was to develop and evaluate a new mobile PHR app that can be easily used to manage various types of personal health data to fill the information gap. Methods: A user-centered approach was used to guide the development and evaluation of the new mobile PHR app. There were three steps in this study: needs assessment, app design and development, and conducting a usability study. First, a large-scale questionnaire study was conducted with the general population to gain an understanding of their needs and expectations with regard to a mobile PHR app. A mobile PHR app for personal medical data tracking and management was then created based on the results of the questionnaire study. End users were actively involved in all stages of the app development. Finally, a usability study was performed with participants to evaluate the usability of the mobile PHR app, which involved asking participants to finish a set of tasks and to respond to a usability questionnaire. Results: In the questionnaire study for needs assessment, there were 609 participants in total. The answers from these participants revealed that they wanted to manage various types of personal health data in a mobile PHR app. Participants also reported some features they desired to have in the app. On the basis of the needs assessment findings, a new mobile PHR app (PittPHR) was created with 6 major modules: health records, history, trackers, contacts, appointments, and resources. This app allows users to customize the trackers according to their needs. In the usability study, there were 15 participants. The usability study participants expressed satisfaction with the app and provided comments and suggestions for further development. Conclusions: This new mobile PHR app provides options for users to manage a wide range of personal health data conveniently in one place. The app fills the information gap between clinical visits. The study results indicated that this new mobile PHR app meets the need of users and that users welcome this app.
BACKGROUND Electronic Personal Health Records (ePHRs) are secure web-based tools that enable individuals to access, manage, and share their medical records. England recently introduced a nationwide ePHR called Patient Online. As with ePHRs in other countries, adoption rates of Patient Online remain low. Understanding factors affecting patients’ use of ePHRs is important to increase adoption rates and improve the implementation success of ePHRs. OBJECTIVE This study aims to examine factors associated with patients’ use of ePHRs in England. METHODS The Unified Theory of Acceptance and Use of Technology (UTAUT) was adapted to the use of ePHRs. To empirically examine the adapted model, a cross-sectional survey of a convenience sample was carried out in four general practices in West Yorkshire, England. Factors associated with use of ePHRs were explored using Structural Equation Modelling (SEM). RESULTS Of 800 eligible patients invited to take part in the survey, 624 (78%) participants returned a valid questionnaire. Behavioural intention was significantly influenced by performance expectancy (β=0.57, P<0.001), effort expectancy (β=0.16, P<0.001), and perceived privacy and security (β=0.24, P<0.001). The path from social influence to behavioural intention was not significant (β=0.03, P=0.183). Facilitating conditions and behavioural intention significantly influenced use behaviour (β=0.25, P<0.001; β=0.53, P<0.001, respectively). Performance expectancy significantly mediated the effect of effort expectancy and perceived privacy and security on behavioural intention (β=0.19, P<0.001; β=0.28, P=0.001, respectively). Age significantly moderated three paths; PEBI, EEBI, and FCUB. Sex significantly moderated only the relationship between performance expectancy and behavioural intention. Two paths were significantly moderated by education and internet access: EEBI and FCUB. Income moderated the relationship between facilitating conditions and use behaviour. The adapted model accounted for 51% of the variance in performance expectancy, 76% of the variance in behavioural intention, and 48% of the variance in use behaviour. CONCLUSIONS This study identified the main factors that affect patients’ use of ePHRs in England, which should be taken into account for the successful implementation of these systems. For example, developers of ePHRs should involve patients in the process of designing the system to consider functions and features that fit patients’ preferences and skills, thereby, create a useful and easy to use system. The proposed model accounted for 48% of the variance in use behaviour, indicating the existence of other, as yet unidentified, factors that influence adoption of ePHRs. Future studies should confirm the effect of the factors included in the current model and to identify additional factors.
The Advanced Symptom Management System (ASyMS) has been developed to facilitate the remote monitoring and management of chemotherapy-related toxicity in patients with cancer, using patient-reported outcomes questionnaires and a clinician alerting system. Objective This study aims to evaluate the usability of the ASyMS, a mobile phone–based technology, from the perspective of Canadian patients with cancer receiving chemotherapy to identify existing design, functionality, and usability issues and elicit their views, experiences, and satisfaction with the ASyMS. Methods We used a mixed-method approach to data collection with user-based testing, a think-aloud technique, semistructured interviews, and short answer questionnaires with a purposive sample of 10 patients with cancer. Participants attended usability testing sessions at the Centre for Global eHealth Innovation, University Health Network, and performed specific tasks on the ASyMS device. The test was videorecorded and each task was timed during the test. After the usability sessions, participants completed a posttest questionnaire and participated in a semistructured qualitative interview. A thematic analysis was used to code and categorize the identified issues into themes that summarized the type and frequency of occurrence. Results The thematic analysis generated 3 overarching themes as follows: ASyMS user-friendliness; usefulness of ASyMS (content quality and richness); and intention to use. Results from the posttest questionnaire indicated that 80% (8/10) of participants had great motivation to use the ASyMS, 70% (7/10) had positive perceptions of the successful use of the ASyMS, and all (10/10, 100%) had a positive attitude toward using the ASyMS in the future. Most identified design and functionality issues were related to the navigation of the ASyMS device and a desire for a more attractive design with advanced functionality and features. The main general design recommendations were as follows: enhance the readability of the screen; implement advance options (eg, search option); and support better navigation. Conclusions The ASyMS has shown positive perceptions of patients in usability testing and qualitative interviews. An evaluation of the effects of the ASyMS on symptom outcomes in a clinical trial is needed.
Patient portals can play an innovative role in facilitating advanced care planning (ACP) and documenting advance directives (ADs) among older adults with multiple chronic conditions. The objective of this qualitative sub-study was to (1) understand older adults' use of an ACP patient portal section and (2) obtain user-design input on AD documentation features. Although some older adults may be reluctant, participants reported likely to use a portal for ADs with proper portal design and support.
Objective: The objective of the systematic review is to explore adult patients' experiences using electronic personal health records (e-PHRs) for chronic non-communicable disease self-management. Introduction: Self-management is a key component of chronic disease management. One of the strategies to support self-management in patients with chronic disease is the use of (e-PHRs). Electronic personal health records offer patients the opportunity to actively engage with their own health information, promote continuity of care and collaboration through disease tracking, and provide patients and providers with an ongoing connection. To adopt e-PHRs and maximize any benefits for chronic disease management, they should align with patients' values and preferences. Inclusion criteria: The review will include qualitative studies that explore the experiences of adult patients (aged 18 years and over) with a chronic non-communicable disease who have used e-PHR for the self-management of their condition. This review will consider studies conducted in any setting or country. Methods: The systematic review will be conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence, with meta-aggregation as the method of synthesis. Published studies will be searched in CINAHL, PubMed, PsycINFO, Embase and Scopus. Gray literature will also be considered. Critical appraisal and data extraction will be conducted using the appropriate JBI tools. Extracted data will be aggregated and analyzed to produce a set of synthesized findings that could be used to develop evidence-informed recommendations for the use of e-PHRs in chronic disease self-management. Systematic review registration number: PROSPERO CRD42019133301.
Information technology (IT) becomes crucial part of the healthcare system and it is getting more attention worldwide. Health IT includes well-known systems that have transformed the health sector, such as electronic health records (EHRs), electronic medical records (EMRs), and electronic personal health records (ePHRs). ePHR aims at enabling patients to take more active role in their care by providing them with a tool to access their health records in a secure and safe environment. The ePHR allows greater patient-provider engagement. The provider’s adoption rate of the ePHR as a tool to connect with patients and to enable them to have access to their records is increasing at an accelerated rate. However, the patient’s ePHR adoption rate remains low. In the United States, the number of office-based physicians adopting EHR increased from 17% in 2008 to 58% as of 2015. Similarly, the non-federal acute care hospitals with certified EHR rate increased from 9% in 2008 to 84% as of 2015 [1]. Despite the efforts to encourage the health care provider’s adoption of certified EHR and ePHR, the adoption rate by patients remains below expectations [2]. The goal of this report is to investigate the key factors influencing the adoption and use of the ePHR in order to understand the patients’ intentions of the adoption and use of such a technology. More attention is needed to improve the patient’s adoption of ePHR. The factors influencing the adoption and use of the ePHR for health management are grouped into six themes. These themes include performance factors, effort factors, social factors, facilitating conditions, perceived credibility, health factors, and computer factors. The themes involve essential factors that influence the adoption and use, such as perceived usefulness, perceived ease of use, portal features, subjective norms, computer and internet availability, computer literacy, computer anxiety, privacy and security, health literacy, satisfaction with medical care, and provider’s support.
Widespread use of health information technology (IT) could potentially increase patients’ access to their health information and facilitate future goals of advancing patient-centered care. Despite having increased access to their health data, patients do not always understand this information or its implications, ...
There is growing interest in electronic access to health information and the use of digital data for both disease and health-related tracking. Widespread use of health information technology (IT) could potential ly increase patients’ access to their health information and facilitate future goals of advancing patient-centered care.1 For example, health IT can be used to facilitate information exchange with clinicians and instruct patients when to act upon clinical issues, such as out of range physiologic parameters, follow-up of test results, and complications of medication use. 2 Tools such as personal health records, patient portals, and various mobile health (mHealth) applications (apps) have been developed to help patients engage in their own care. Already, a significant number of patients use health IT; therefore, it is essential that patient-facing health IT be tailored to their needs. In this paper, we discuss two forms of patient-facing health IT tools—patient portals and apps—to highlight how, despite several limitations of each, combining high-yield features of mHealth apps with portals could increase patient engagement and self-management and be more effective than either of them alone. This could potentially improve both patient experience and outcomes related to patient-facing health IT.
This statement accompanies the article Patient portals and health apps: Pitfalls, promises, and what one might learn from the other authored by Jessica L. Baldwin and co-authored by Hardeep Singh, Dean F. Sittig, Traber Davis Giardina and submitted to Healthcare as an Article Type. Authors collectively affirm that this manuscript represents original work that has not been published and is not being considered for publication elsewhere.We also affirm that all authors listed contributed significantly to the project and manuscript. Furthermore we confirm that none of our authors have disclosures and we declare noconflict of interest.
Patient portals are intended to engage patients by giving them access to medical information ; however, if patients are unable to understand the information or the system is not usable, patients will not take advantage of them. Despite several aforementioned drawbacks, apps have used evolving innovative designs to engage consumers and offer unique features and functions that could be translated to patient portal design. For instance, Apple's ResearchKit's Diabetes app pings the user daily to update disease and symptom-related information. Check-in questions or user-friendly alerts in portals could similarly be explored for engaging more patients their health care. Alerts could ask if the patient understands an abnormal result, direct them to helpful resources, and encourage test result follow-up. Finally, test results in the portal need to be easily understood by laypeople or displayed using simplified medical terms. For example, a portal might display elevated cholesterol as "↑LDL cholesterol," or even just display the number without a flag, whereas a health app may label it as “bad cholesterol.”
In June 2014, Apple announced the HealthKit cloud application programming interface (API) and its partnership with Epic (Verona, WI), an electronic health record vendor who also makes MyChart (a popular patient portal), and the Mayo Clinic (Rochester, MN).