Inpatient Portals for Hospitalized Patients and Caregivers: A Systematic Review

Abstract

Patient portals, web-based personal health records linked to electronic health records (EHRs), provide patients access to their healthcare information and facilitate communication with providers. Growing evidence supports portal use in ambulatory settings; however, only recently have portals been used with hospitalized patients. Our objective was to review the literature evaluating the design, use, and impact of inpatient portals, which are patient portals designed to give hospitalized patients and caregivers inpatient EHR clinical information for the purpose of engaging them in hospital care. Literature was reviewed from 2006 to 2017 in PubMed, Web of Science, CINALPlus, Cochrane, and Scopus to identify English language studies evaluating patient portals, engagement, and inpatient care. Data were analyzed considering the following 3 themes: inpatient portal design, use and usability, and impact. Of 731 studies, 17 were included, 9 of which were published after 2015. Most studies were qualitative with small samples focusing on inpatient portal design; 1 nonrandomized trial was identified. Studies described hospitalized patients' and caregivers' information needs and design recommendations. Most patient and caregiver participants in included studies were interested in using an inpatient portal, used it when offered, and found it easy to use and/or useful. Evidence supporting the role of inpatient portals in improving patient and caregiver engagement, knowledge, communication, and care quality and safety is limited. Included studies indicated providers had concerns about using inpatient portals; however, the extent to which these concerns have been realized remains unclear. Inpatient portal research is emerging. Further investigation is needed to optimally design inpatient portals to maximize potential benefits for hospitalized patients and caregivers while minimizing unintended consequences for healthcare teams.

A systematic review of patient access to medical records in the acute setting: practicalities, perspectives and ethical consequences

“…More recently, the use of patient 'portals'an electronic route to targeted parts of the medical recordhas become more common. Several systematic reviews on the design, use and impact of such portals have been conducted [12][13][14]. Patients are generally enthusiastic about the possibility of accessibility, and positive or neutral health outcomes were observed.…”

Digital Technology: Opportunities and barriers for usage of personal health records in hospital – report from a ­workshop of the Health Informatics Unit at the Royal ­College of Physicians

“…16 There is currently little published evidence on use or impact of PHRs by hospital patients or staff, before, during or after a hospital encounter. 17 The aim of the paper is to explore opportunities and barriers for usage of PHRs in hospital by summarising inputs and discussions from a workshop of the Health Informatics Unit at the RCP.…”

Parent Perceptions of Real-time Access to Their Hospitalized Child’s Medical Records Using an Inpatient Portal: A Qualitative Study

“…Inpatient portals are Web-based applications on tablet computers that provide real-time access to clinical information from the electronic health record (EHR) (eg, diagnoses, medications, test results, and education). 3 Research with adult inpatients and/or caregivers [4][5][6][7][8][9][10][11][12][13][14][15][16][17] and families of children who are hospitalized and undergoing a bone marrow transplant [18][19][20][21] suggests that use of an inpatient portal may play a role in improving patient and caregiver knowledge. Whether inpatient portals would similarly be used by and provide benefits for parents of children hospitalized with general medical and surgical conditions was unknown.…”