Engaging Adolescents in Using Online Patient Portals

Sisk, Bryan A.; Antes, Alison L.; Bereitschaft, Christine; Enloe, Madi; Lin, Sunny; Srinivas, Meghana; Bourgeois, Fabienne; DuBois, James M.

doi:10.1001/jamanetworkopen.2023.30483

Cited by 7 publications

(2 citation statements)

References 32 publications

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“…A qualitative study exploring strategies and barriers to engage adolescent patient portal use emphasised the need for content and functions tailored speci cally for adolescents, targeted promotions for the patient portal, and adolescent-speci c education about the patient portal (45). Yet, a pilot study reported that educating adolescents about their access to the patient portal, including privacy considerations and functionality, resulted in improved patient portal enrollment but not usage (42).…”

Section: Transition Into Adult Carementioning

confidence: 99%

Adolescents’ experiences of using patient portals in mental health care - a qualitative study

Nielsen,

Steinsbekk,

Nøst

2024

Preprint

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Background Adolescents in mental health care are gradually expected to assume greater responsibility for their health care. Patient portals may aid adolescents in this process by providing opportunities for treatment management and easier access to clinical information from their electronic health record (EHR). However, there is limited knowledge of how adolescents in mental health care experience using patient portals. Therefore, the aim of the current study was to explore adolescents´ experiences of using patient portals in mental health care. Methods A qualitative study with individual semi-structured interviews with 17 persons who had experiences from using patient portals in child and adolescent specialist mental health care. The main questions concerned how they experienced using a patient portal, how they experienced using different features in the patient portal, and how access had affected their relationship with their healthcare provider. Results The data were categorised into three themes: “A tool to assume responsibility”, “To be in control” and “A better understanding vs. negative reactions”. The informants talked about how they had used the patient portal to aid treatment management and that this had helped in their transition into adult care. The feature in the patient portal that the informants talked most about was the access to clinical notes written by healthcare providers. Reading the notes was said to give the informants a better understanding of their condition and helped them to track progress. Still, it could also cause distress and divert attention from their daily activities. Conclusion The informants´ experiences with using a patient portal in child and adolescent mental health care varied from managing treatment and getting a better understanding of their situation, to causing distress and challenging the trust in their healthcare providers.

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Section: Transition Into Adult Carementioning

confidence: 99%

Adolescents’ experiences of using patient portals in mental health care - a qualitative study

Nielsen,

Steinsbekk,

Nøst

2024

Preprint

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“…We interviewed 65 informatics administrators from multiple health systems across the United States. Our prior analysis of these interviews characterized the varying adolescent portal policies across the United States [ 16 ], as well as approaches to engaging adolescents in using the portal [ 25 ]. In this analysis, we aimed to identify guiding principles to inform the development of these policies in the future.…”

Section: Introductionmentioning

confidence: 99%

Guiding Principles for Adolescent Web-Based Portal Access Policies: Interviews With Informatics Administrators

Sisk,

Antes,

Bereitschaft

et al. 2024

JMIR Pediatr Parent

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Background Web-based patient portals are tools that could support adolescents in managing their health and developing autonomy. However, informatics administrators must navigate competing interests when developing portal access policies for adolescents and their parents. Objective We aimed to assess the perspectives of informatics administrators on guiding principles for the development of web-based health care portal access policies in adolescent health care. Methods We interviewed informatics administrators from US hospitals with ≥50 dedicated pediatric beds. We performed a thematic analysis of guiding principles for developing and implementing adolescent portal access policies. Results We interviewed 65 informatics leaders who represented 63 pediatric hospitals, 58 health care systems, 29 states, and 14,379 pediatric hospital beds. Participants described 9 guiding principles related to three overarching themes: (1) balancing confidentiality and other care needs, (2) balancing simplicity and granularity, and (3) collaborating and advocating. Participants described the central importance of prioritizing the health and safety of the adolescent while also complying with state and federal laws. However, there were differing beliefs about how to prioritize health and safety and what role parents should play in supporting the adolescent’s health care. Participants also identified areas where clinicians and institutions can advocate for adolescents, especially with electronic health record vendors and legislators. Conclusions Informatics administrators provided guiding principles for adolescent portal access policies that aimed to balance the competing needs of adolescent confidentiality and the usefulness of the portal. Portal access policies must prioritize the adolescent’s health and safety while complying with state and federal laws. However, institutions must determine how to best enact these principles. Institutions and clinicians should strive for consensus on principles to strengthen advocacy efforts with institutional leadership, electronic health record vendors, and lawmakers.

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Automatic Enrollment in Patient Portal Systems Mitigates the Digital Divide in Healthcare: An Interrupted Time Series Analysis of an Autoenrollment Workflow Intervention

Milanfar,

Soulsby,

Ling

et al. 2024

J Med Syst

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Purpose Racial and ethnic healthcare disparities require innovative solutions. Patient portals enable online access to health records and clinician communication and are associated with improved health outcomes. Nevertheless, a digital divide in access to such portals persist, especially among people of minoritized race and non-English-speakers. This study assesses the impact of automatic enrollment (autoenrollment) on patient portal activation rates among adult patients at the University of California, San Francisco (UCSF), with a focus on disparities by race, ethnicity, and primary language. Materials and methods Starting March 2020, autoenrollment offers for patient portals were sent to UCSF adult patients aged 18 or older via text message. Analysis considered patient portal activation before and after the intervention, examining variations by race, ethnicity, and primary language. Descriptive statistics and an interrupted time series analysis were used to assess the intervention’s impact. Results Autoenrollment increased patient portal activation rates among all adult patients and patients of minoritized races saw greater increases in activation rates than White patients. While initially not statistically significant, by the end of the surveillance period, we observed statistically significant increases in activation rates in Latinx (3.5-fold, p = < 0.001), Black (3.2-fold, p = 0.003), and Asian (3.1-fold, p = 0.002) patient populations when compared with White patients. Increased activation rates over time in patients with a preferred language other than English (13-fold) were also statistically significant (p = < 0.001) when compared with the increase in English preferred language patients. Conclusion An organization-based workflow intervention that provided autoenrollment in patient portals via text message was associated with statistically significant mitigation of racial, ethnic, and language-based disparities in patient portal activation rates. Although promising, the autoenrollment intervention did not eliminate disparities in portal enrollment. More work must be done to close the digital divide in access to healthcare technology.

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Engaging Adolescents in Using Online Patient Portals

Cited by 7 publications

References 32 publications

Adolescents’ experiences of using patient portals in mental health care - a qualitative study

Adolescents’ experiences of using patient portals in mental health care - a qualitative study

Guiding Principles for Adolescent Web-Based Portal Access Policies: Interviews With Informatics Administrators

Automatic Enrollment in Patient Portal Systems Mitigates the Digital Divide in Healthcare: An Interrupted Time Series Analysis of an Autoenrollment Workflow Intervention

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