7 hours ago · Articles reviewed rarely analyzed a full patient portal but instead analyzed features of a portal such as secure messaging, as well as disease management and monitoring. The ability of patients to be able to view their health information electronically meets the intent of Meaningful Use, Stage 2 requirements, but the ability to transmit to a ... >> Go To The Portal
Numeracy (specifically health numeracy) is defined as “…the degree to which individuals have the capacity to access, process, interpret, communicate, and act on numerical, quantitative, graphical, biostatistical, and probabilistic health information needed to make effective health decisions” (Golbeck, Ahlers-Schmidt, Paschal, & Dismuke, 2005, p.
Goldbeck, Ahlers-Schmidt, Paschal, and Dismuke (2005) suggest that numeracy consists of four main skills: Basic (e.g., identifying numbers), computational (e.g., simple manipulation of numbers), analytical (e.g., inferences, estimations and proportions), and statistical (e.g., probability, risk evaluation).
Indeed, after reviewing earlier literature (e.g., Lipkus, Samsa, & Rimer, 2001) as well as their own findings, Brown et al. (2011) maintained that education level does not predict numeracy. In a series of studies, Peters et al. (2006) showed that high- and low-numeracy individuals process information differently.
Most of the studies assessed implementation of patient portals using interim outcomes such as user perceptions, and few studies addressed important objective outcomes such as length of stay, morbidity, or mortality [2,4,20,54].
The inputs are the material (eg, hardware and software) and nonmaterial (eg, leadership) components that facilitate or impair the establishment or use of the portal. Processes include the interactions of the users with the portal. Outputs comprise the results of the implementation or the use of the portal. Through the analysis, we identified 14 themes within these three categories, shown in Textbox 1.
While the evidence is currently immature, patient portals have demonstrated benefit by enabling the discovery of medical errors, improving adherence to medications, and providing patient-provider communication, etc. High-quality studies are needed to fully understand, improve, and evaluate their impact.
Promoting patient involvement in health care delivery may lead to improved quality and safety of care [14,15] by enabling patients to spot and report errors in EMRs, for example [6]. Some patients recognize the role of patient portals in their health care, reporting satisfaction with the ability to communicate with their health care teams and perform tasks such as requesting prescription refills conveniently [3,16]. Portal use may reduce in-person visits, visits to emergency departments, and patient-provider telephone conversations [3,8-10,12,16]. Despite the potential of portals, already used in the ambulatory setting for some time, implementation in the inpatient setting has only recently gathered momentum [17-19]. The inpatient setting presents additional challenges for implementing patient portals [18,20]. Clinical conditions leading to hospitalization are often acute and the amount of medical information generated during this time can be extensive, which may overwhelm patients [20] and challenge information technology to rapidly display this information.
Hospitals and other health care organizations can facilitate patient access to their EMR information through patient portals. 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].
The systematic search identified 58 articles for inclusion. The inputs category was addressed by 40 articles, while the processes and outputs categories were addressed by 36 and 46 articles, respectively: 47 articles addressed multiple themes across the three categories, and 11 addressed only a single theme. Nineteen articles had high- to very high-quality, 21 had medium quality, and 18 had low- to very low-quality. Findings in the inputs category showed wide-ranging portal designs; patients’ privacy concerns and lack of encouragement from providers were among portal adoption barriers while information access and patient-provider communication were among facilitators. Several methods were used to train portal users with varying success. In the processes category, sociodemographic characteristics and medical conditions of patients were predictors of portal use; some patients wanted unlimited access to their EMRs, personalized health education, and nonclinical information; and patients were keen to use portals for communicating with their health care teams. In the outputs category, some but not all studies found patient portals improved patient engagement; patients perceived some portal functions as inadequate but others as useful; patients and staff thought portals may improve patient care but could cause anxiety in some patients; and portals improved patient safety, adherence to medications, and patient-provider communication but had no impact on objective health outcomes.
Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication.
The PubMed, CINAHL, and Embase databases were searched for articles published between 2005 and 2017 using keywords related to patient engagement, electronic health records, patient portals, and their associated subject headings in each database: the full search terms for each database are provided in Multimedia Appendix 1.
The email address and/or password entered does not match our records, please check and try again.
Did you struggle to get access to this article? This product could help you
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click on download.
1 ), parents' numeracy beliefs uniquely and differentially influence the frequency and complexity of their numeracy support and are differentially influenced by parents' socioeconomic status and children's age. Parents' numeracy beliefs about their children were more consistently related to their numeracy support than their numeracy beliefs about themselves or about learning numeracy in general but were inconsistently related to parent and child demographic characteristics. Parents' numeracy beliefs about themselves were related to the complexity, but not the frequency, of their numeracy support according to most studies. Parents' numeracy beliefs about themselves were also related to their socioeconomic status according to most studies. Overall, evidence to date supports focusing on how parents' socioeconomic status (SES) influences their numeracy beliefs and numeracy support. Further, our understanding of parents' early numeracy support will be strengthened by additional research on their early numeracy beliefs including their malleability, on other factors that likely influence their early numeracy beliefs and support, and on how parents' early numeracy beliefs influence the development of their children's numeracy skills and beliefs.
Because older adults tend to be less numerate than their younger counterparts, they may be at higher risk for poor financial decision-making.
Numeracy (specifically health numeracy) is defined as “…the degree to which individuals have the capacity to access, process, interpret, communicate, and act on numerical, quantitative, graphical, biostatistical, and probabilistic health information needed to make effective health decisions” (Golbeck, Ahlers-Schmidt, Paschal, & Dismuke, 2005, p.
In addition to cognitive ability, numeracy— or the ability to identify, understand, critically interpret and apply mathematical concepts, processes, and representations— is a second but related key factor important for financial decision making. An extensive line of research has shown that possessing financial literacy, including the ability to understand financial terms, be engaged in financial markets, or judge financial information, enables people to employ knowledge and skills to manage financial resources effectively for a lifetime of financial well-being (Lusardi & Mitchell, 2011 ). Numeracy appears to be independent of education and general intellectual abilities (IQ). Indeed, after reviewing earlier literature (e.g., Lipkus, Samsa, & Rimer, 2001) as well as their own findings, Brown et al. (2011) maintained that education level does not predict numeracy. In a series of studies, Peters et al. (2006) showed that high- and low-numeracy individuals process information differently. High-numeracy adults were at greater ease in transforming numbers from one unit of measurement to another, and more likely to utilize the correct numerical principles. Low-numeracy individuals, on the other hand, were “left with information that is less complete and less understood, lacking in the complexity and richness available to the more numerate” (2006, p. 412), suggesting that low-numeracy individuals processed information less efficiently.
Overall, unless the task requires specific verbatim information retrieval, older adults should demonstrate superior understanding of numerical health information by integrating domain-related knowledge and affective responses, using heuristics at the level of gist representation, which should mitigate the demands on health literacy and numeracy skills, and cognitive abilities more broadly, as illustrated on Fig. 3.1. More specifically, the affective avenue and the associations to familiar and previous experiences can be used to leverage EHR designs and gist comprehension ( Morrow & Chin, 2015; Morrow et al., 2017; see also Garcia-Retamero & Cokely, 2011 ).
In the health-domain, Federal “meaningful use” EHR guidelines require health organizations to provide patients results from lipid panel, blood glucose, MRI, and other complex tests through portals ( IOM, 2012 ). This use arises from the Medicare and Medicaid EHRs Incentive Programs, designed to improve patient care ( Black et al., 2015; Schapira et al., 2017 ). Although these requirements mandate providing patients with this information, there is no corresponding guidance about effective formats for communicating the information to older adults. In health care, patients with lower numeracy are more likely to misunderstand test results, undermining health decisions, behaviors, and outcomes ( Apter et al., 2008; Black et al., 2015 ).
Goldbeck, Ahlers-Schmidt, Paschal, and Dismuke (2005) suggest that numeracy consists of four main skills: Basic (e.g., identifying numbers), computational (e.g., simple manipulation of numbers), analytical (e.g., inferences, estimations and proportions), and statistical (e.g., probability, risk evaluation). Analogous to the concept of “functional literacy” is the concept of “functional numeracy” which involves the ability to appropriately apply math skills to perform particular tasks and figuring out which math skills are needed in a given context. It has been commonplace to accept that both literacy and numeracy skills are essential to everyday life given the variety of numerical information that we process daily ( Castel, 2007; Peters, 2012 ). As mentioned by Peters (2012), numerical information must frequently be considered when making decisions, but numbers can be difficult to evaluate because they are abstract symbols, and context changes their evaluative meaning (e.g., 9°F, $9 billion, 9% chance of a tsunami).
Many patients have low health literacy skills, and have difficulty with reading, writing, numeracy, communication, and, increasingly, the use of electronic technology, which impede access to and understanding of health care information.
Multiple professional organizations recommend using universal health literacy precautions to provide understandable and accessible information to all patients, regardless of their literacy or education levels.
Health literacy is linked to literacy and entails people's knowledge, motivation and competences to access, understand, appraise and apply health information in order to make judgements and take decisions in everyday life concerning health care, disease prevention and health promotion to maintain or improve quality of life during the life course.