Developing an Integrated Caregiver Patient-Portal System

Longacre, Margaret L.; Keleher, Cynthia; Chwistek, Marcin; Odelberg, Michelle; Siemon, Mark; Collins, Molly; Fang, Carolyn Y.

doi:10.3390/healthcare9020193

Cited by 14 publications

(22 citation statements)

References 46 publications

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“…The ability to access patient health information was consistently identified as facilitating care partner portal use (8 of 12 articles), 22 , 26 , 42 , 44 , 45 , 59 , 60 , 61 with the remaining 4 articles 49 , 50 , 52 , 62 emphasizing importance without specifying directionality and identifying care coordination (eg, messaging, appointment scheduling, and filling prescriptions) as facilitating care partner portal use (8 articles). 30 , 40 , 42 , 45 , 50 , 52 , 59 , 61 …”

Section: Resultsmentioning

confidence: 99%

Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

et al. 2022

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ImportanceFamily and other unpaid care partners may bridge accessibility challenges in interacting with the patient portal, but the extent and nature of this involvement is not well understood.ObjectiveTo inform an emerging research agenda directed at more purposeful inclusion of care partners within the context of digital health equity by (1) quantifying care partners’ uptake and use of the patient portal in adolescent and adult patients, (2) identifying factors involving care partners’ portal use across domains of the System Engineering Initiative for Patient Safety model, and (3) assessing evidence of perceived or actual outcomes of care partners’ portal use.Evidence ReviewFollowing Arksey and O’Malley’s methodologic framework, a scoping review of manuscripts published February 1 and March 22, 2022, was conducted by hand and a systematic search of PubMed, PsycInfo, Embase, and Web of Science. The search yielded 278 articles; 125 were selected for full-text review and 41 were included.FindingsFew adult patient portal accounts had 1 or more formally registered care partners (&lt;3% in 7 of 7 articles), but care partners commonly used the portal (8 of 13 contributing articles reported &gt;30% use). Care partners less often authored portal messages with their own identity credentials (&lt;3% of portal messages in 3 of 3 articles) than with patient credentials (20%-60% of portal messages in 3 of 5 articles). Facilitators of care partner portal use included markers of patient vulnerability (13 articles), care partner characteristics (15 articles; being female, family, and competent in health system navigation), and task-based factors pertaining to ease of information access and care coordination. Environmental (26 articles) and process factors (19 articles, eg, organizational portal registration procedures, protection of privacy, and functionality) were identified as influential to care partner portal use, but findings were nuanced and precluded reporting on effects. Care partner portal use was identified as contributing to both patient and care partner insight into patient health (9 articles), activation (7 articles), continuity of care (8 articles), and convenience (6 articles).Conclusions and RelevanceIn this scoping review, care partners were found to be infrequently registered for the patient portal and more often engaged in portal use with patient identity credentials. Formally registering care partners for the portal was identified as conferring potential benefits for patients, care partners, and care quality.

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Section: Resultsmentioning

confidence: 99%

Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

et al. 2022

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“…Discharge summary handouts are frequently not tailored for the care needs of patients and carers or are written at higher reading levels, limiting the ability to understand postdischarge instructions 40. In ambulatory settings, patient portals have supported patient engagement in self-care and improved communication between patients and clinicians41 and are being adapted to support carer inclusion 42. However, implementation of patient portals in acute care settings has encountered several barriers, such as portal access during hospitalisation 43 44.…”

Section: Discussionmentioning

confidence: 99%

Mixed-methods study examining family carers’ perceptions of the relationship between intrahospital transitions and patient readiness for discharge

et al. 2022

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IntroductionIntrahospital transitions (IHTs) represent movements of patients during hospitalisation. While transitions are often clinically necessary, such as a transfer from the emergency department to an intensive care unit, transitions may disrupt care coordination, such as discharge planning. Family carers often serve as liaisons between the patient and healthcare professionals. However, carers frequently experience exclusion from care planning during IHTs, potentially decreasing their awareness of patients’ clinical status, postdischarge needs and carer preparation. The purpose of this study was to explore family carers’ perceptions about IHTs, patient and carer ratings of patient discharge readiness and carer self-perception of preparation to engage in at home care.MethodsSequential, explanatory mixed-methods study involving retrospective analysis of hospital inpatients from a parent study (1R01HS026248; PI Wallace) for whom patient and family carer Readiness for Hospital Discharge Scale (RHDS) score frequency of IHTs and patient and caregiver characteristics were available. Maximum variation sampling was used to recruit a subsample of carers with diverse backgrounds and experiences for the participation in semistructured interviews to understand their views of how IHTs influenced preparation for discharge.ResultsOf discharged patients from July 2020 to April 2021, a total of 268 had completed the RHDS and 23 completed the semistructured interviews. Most patients experienced 0–2 IHTs and reported high levels of discharge readiness. During quantitative analysis, no association was found between IHTs and patients’ RHDS scores. However, carers’ perceptions of patient discharge readiness were negatively associated with increased IHTs. Moreover, non-spouse carers reported lower RHDS scores than spousal carers. During interviews, carers shared barriers experienced during IHTs and discussed the importance of inclusion during discharge care planning.ConclusionsIHTs often represent disruptive events that may influence carers’ understanding of patient readiness for discharge to home and, thus, their own preparation for discharge. Further consideration is needed regarding how to support carers during IHT to facilitate high-quality discharge planning.

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“…Second, the interview participants stressed the key role of training and ongoing support to increase their self-efficacy using the technology platform. Ongoing training and support were suggested as effective strategies to attract and involve key stakeholders in implementing or using the innovation [ 33 , 34 ]. Our results in the implementation process domain provide insight into the participants’ thoughts on the ongoing training performed.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Statewide Web-Based Caregiver Resource Information System (CareNav): Mixed Methods Study

Young¹,

Bell²,

Tonkikh³

et al. 2022

JMIR Form Res

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Background With the aging population, family caregivers provide increasingly complex and intense care for older adults and persons with disabilities. There is growing interest in developing community-based services to support family caregivers. Caregiving occurs around the clock, and caregivers face challenges in accessing community-based services at convenient times owing to the demands of care. Web-based resources hold promise for accessible real-time support. CareNav (TM), a caregiver resource information system, is a web-based platform designed to support real-time universal caregiver assessment, a record of client encounters, development of a care plan, tailored information and resource content, access to web-based caregiver resources, the capacity to track service authorization and contracts, and secure communications. The assessment includes needs and health conditions of both the care recipient and caregiver; current resources; and priorities for support, information, and referral. In 2019, the California Department of Health Care Services funded the 11 nonprofit California Caregiver Resource Centers (CRCs) to expand and improve family caregiver services and enhance CRC information technology services. Deployment of a statewide information system offered a unique opportunity to examine structures and processes facilitating implementation, providing feedback to the sites as well as lessons learned for similar projects in the future. Objective The aim of this paper was to describe the statewide implementation of the comprehensive CareNav system using the Consolidated Framework for Implementation Research as an organizing structure for synthesizing the evaluation. Methods This mixed methods study used two major approaches to evaluate the implementation process: a survey of all staff who completed training (n=82) and in-depth qualitative interviews with 11 CRC teams and 3 key informants (n=35). We initially analyzed interview transcripts using qualitative descriptive methods and then identified subthemes and relationships among ideas, mapping the findings to the Consolidated Framework for Implementation Research. Results We present findings on the outer setting, inner setting, characteristics of the intervention, characteristics of the staff, and the implementation process. The critical elements for success were leadership, communication, harmonization of processes across sites, and motivation to serve clients in more accessible and convenient ways. Conclusions These findings have implications for technology deployment in diverse community-based agencies that aspire to enhance web-based services.

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Developing an Integrated Caregiver Patient-Portal System

Cited by 14 publications

References 46 publications

Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations

Mixed-methods study examining family carers’ perceptions of the relationship between intrahospital transitions and patient readiness for discharge

Implementation of a Statewide Web-Based Caregiver Resource Information System (CareNav): Mixed Methods Study

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