Meaningful use of the electronic patient portal – Virginia Mason's journey to create the perfect online patient experience

Kamo, Norifumi; Bender, Adam; Kalmady, Kavitha; Blackmore, C. Craig

doi:10.1016/j.hjdsi.2016.09.003

Cited by 19 publications

(19 citation statements)

References 13 publications

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“…Most respondents prefer a summary of the medical information in laymen’s terms, presenting less but more understandable information, above a complete uncensored medical file. Our study therefore supports the idea that patients experience difficulties in understanding the medical information and jargon published in patient portals [ 31 – 33 , 39 – 41 ]. In developing patient portals, we advise to consider customized features in which the provider can manually edit the content before publication.…”

Section: Discussionsupporting

confidence: 87%

How do patients value and prioritize patient portal functionalities and usage factors? A conjoint analysis study with chronically ill patients

Wildenbos

Horenberg

Jaspers

et al. 2018

BMC Med Inform Decis Mak

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BackgroundPatient portal use can be a stimulant for patient engagement. Yet, the heterogeneous landscape of tethered patient portals, is a major barrier to further portal development and implementation. A variety in portal access means, functionalities, usability and usefulness exists; without having accurate sight on patient perspectives. We aimed to get insights on possible coherence between patients’ preferred usage factors of portals and patients’ prioritization of functionalities, within the complexity of their disease management across different healthcare organizations.MethodsA conjoint analysis questionnaire was sent to patient panels of two large patient associations in The Netherlands, centered on heart and vascular diseases and lung diseases.ResultsOf 1294 patient respondents, 81% were 55+ years old and 49% were 65+ years old. Overall respondents significantly prioritized user-friendly access to a portal, via a laptop or desktop. Patients aged < 65 were less negative about using tablets to access a portal compared to the total respondents. Patients had no preference for a digital interoperable export functionality; most respondents preferred to create printable overviews. Built-in publication delay of two weeks for medical information was not preferred. Our results show no significant preference of patients between ‘instant publication’ versus ‘publication after new information has been explained by a healthcare provider’. Overall respondents and experienced portal users had a strong preference to be able to communicate with their provider via a portal and to use a portal providing information from multiple providers. Lung patients preferred information from one provider and did not require the possibility to ask online questions.ConclusionsHeart and vascular patients as well as lung patients prefer similar technical patient portal aspects, independent of their medical condition. Yet, in current portals consistency on this matter is lacking. It is highly assumable that offering a more consistent user-experience across the variety of patient portals could help increase patient portal acceptance, ultimately helping to stimulate patient engagement via patient portal use. We further affirm the need for customization on medical information publication and sharing information of various providers through patient portals, where information provision can be adapted to preferences of patients related to their medical condition(s).Electronic supplementary materialThe online version of this article (10.1186/s12911-018-0708-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

How do patients value and prioritize patient portal functionalities and usage factors? A conjoint analysis study with chronically ill patients

Wildenbos

Horenberg

Jaspers

et al. 2018

BMC Med Inform Decis Mak

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“…Growing evidence on the benefits of patient engagement has fueled health systems’ focus on patient portals as a central access point for the future of primary care [ 1 , 2 ]. The financial incentives of the Meaningful Use Program, as part of the US health care reform in 2014, spurred a rapid uptake of patient portals across health systems nationwide [ 3 - 5 ]. Emerging national evidence in the last 5 years indicates that the digital divide is shrinking, as 80% of the US population owns internet-accessible smartphones, without differences by race or ethnicity and with few differences across income categories nationally, especially when it comes to mobile use [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

An Untapped Potential in Primary Care: Semi-Structured Interviews with Clinicians on How Patient Portals Will Work for Caregivers in the Safety Net

Casillas¹,

Cemballi²,

Abhat³

et al. 2020

J Med Internet Res

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Background Patients within safety-net settings are less likely to access health information on patient portals, despite expressed interest. Family and friends are important resources to assist these patients (ie, Medicaid recipients, older patients, patients with limited English proficiency) in navigating health systems, and provider support of the use of patient portals among these groups may also facilitate caregivers’ use of their patients’ portal. Objective Because safety net providers work closely with caregivers to care for their patients, we used qualitative methods to explore safety net providers’ perspectives on portal use among caregivers for their patients, especially as there is limited literature about caregivers’ use of portals in the safety net. Methods We conducted 45- to 60-min semistructured telephone interviews with providers from three large California safety-net health systems. The interviews focused on providers’ experiences with caregivers, caregiver roles, and how the portal could be leveraged as a tool to support caregivers in their responsibilities. A total of three coders analyzed the interview transcripts using both deductive and inductive approaches and established a consensus regarding major themes. Results Of the 16 participants interviewed, 4 specialized in geriatrics, and all held a leadership or administrative role. We described themes highlighting providers’ recognition of potential benefits associated with caregiver portal use and specific challenges to caregiver engagement. Conclusions Providers recognized the potential for portals to improve information delivery and communication by helping caregivers assist socially and medically complex patients in the safety net. Providers in safety net sites also discussed a clear need for better ways to keep in touch with patients and connect with caregivers, yet security and privacy are perhaps of higher importance in these settings and may pose challenges to portal adoption. They noted that caregivers of patients in the safety net likely face similar communication barriers as patients, especially with respect to digital literacy, health literacy, and English proficiency. Further research is needed to assess and support caregivers’ interest and ability to access portals across barriers in health and digital literacy, and English proficiency. Portal platforms and health systems must also address specific strategies to uphold patient preferences while maintaining privacy and security.

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“…3 Growing evidence that portal use is associated with patient-centered care has spurred systems to focus on portals as an access point for the future of primary care. 4,5 The financial incentives of the Meaningful Use Program, as part of U.S. healthcare reform in 2014 triggered a rapid uptake of portals across health systems nationwide [6][7][8][9] -including in the safety net. Almost 2 decades after the inception of patient portals, systems that make up the safety net and provide care to large proportions of minority, lowincome, limited English proficient (LEP), and other vulnerable patients, are implementing patient portals for the first time.…”

Section: Introductionmentioning

confidence: 99%

Su salud a la mano (your health at hand): patient perceptions about a bilingual patient portal in the Los Angeles safety net

Casillas

Perez-Aguilar

Abhat

et al. 2019

Journal of the American Medical Informatics Association

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Objectives Driven by beneficial patient-centered outcomes associated with patient portal use and the Affordable Care Act, portal implementation has expanded into safety nets—health systems that offer access to care to a large share of uninsured, Medicaid, and other vulnerable populations. However, little attention has been paid to the factors that affect portal accessibility by the vulnerable patients served by these health systems—including those who are limited English proficient (LEP). Materials and Methods The Los Angeles County Department of Health Services (LAC DHS), the second-largest safety net system in the nation, launched its first patient portal, and one of the few bilingual English-Spanish interfaces in existence, in March of 2015. To explore portal awareness and perceptions, we conducted focus groups with LAC DHS patients, in English and Spanish (LEP). The Technology Acceptance Model was used to guide thematic analysis of focus group data. Results Of the 46 participants, 37 were patients and 9 were caretakers; 23 were English-speaking and 23 Spanish-speaking LEP. All patients had diabetes or hypertension. Over half had an annual household income <$10 000, yet 78% of English-speaking and 65% of Spanish-speaking LEP participants reported at-home Internet access. Participants’ discussion centered around 3 major thematic narratives: (1) participants’ awareness or attitudes about the LAC DHS portal; (2) role of culture, language, or community with regard to portal accessibility and utility; and (3) perceived needs for successful portal implementation. Conclusions Safety net participants identified concrete benefits to the portal and emphasized the need for portal engagement that offered accessible education, support, and resources in clinical and community settings. The portal offers an additional opportunity to engage the patient and family with trusted and validated health information, and should be further developed in this capacity. This study provides a better understanding of preferred improvements of patient portal engagement that guide broader health technology efforts to address electronic health disparities.

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Meaningful use of the electronic patient portal – Virginia Mason's journey to create the perfect online patient experience

Cited by 19 publications

References 13 publications

How do patients value and prioritize patient portal functionalities and usage factors? A conjoint analysis study with chronically ill patients

How do patients value and prioritize patient portal functionalities and usage factors? A conjoint analysis study with chronically ill patients

An Untapped Potential in Primary Care: Semi-Structured Interviews with Clinicians on How Patient Portals Will Work for Caregivers in the Safety Net

Su salud a la mano (your health at hand): patient perceptions about a bilingual patient portal in the Los Angeles safety net

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