Patient Access to Electronic Health Records During Hospitalization

Pell, Jonathan; Mancuso, Mary; Limon, Shelly; Oman, Kathy; Lin, Chen-Tan

doi:10.1001/jamainternmed.2015.121

Cited by 40 publications

(43 citation statements)

References 4 publications

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“…[29][30][31][32][33][34][35][36] There is still only a rudimentary understanding of how PHRs can contribute to improving inpatient experience and increasing patient engagement in the hospital setting. [37] 5.1 Implications…”

Section: Discussionmentioning

confidence: 99%

“…Further, sharing information has been shown to reduce patient requests for clinicians' time, foster a sense of control and empowerment while promoting self-efficacy and ownership of illness [16][17][18], and lead to increased participation as an informed partner in making health decisions [19][20][21][22]. Previous research suggests that patients want to use PHRs and believe that they will be valuable [23].…”

Section: Introductionmentioning

confidence: 99%

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Patient Experiences Using an Inpatient Personal Health Record

Woollen¹,

Prey²,

Wilcox³

et al. 2016

Appl Clin Inform

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SummaryObjective: To investigate patients' experience using an inpatient personal health record (PHR) on a tablet computer to increase engagement in their hospital care. Methods: We performed observations and conducted semi-structured interviews with 14 post-operative cardiac surgical patients and their family members who received an inpatient PHR. Themes were identified using an inductive coding scheme. Results: All participants responded favorably to having access to view their clinical information. A majority (85.7%) of participants used the application following an initial training session. Patients reported high satisfaction with being able to view their hospital medications and access educational materials related to their medical conditions. Patients reported a desire to view daily progress reports about their hospital stay and have access to educational information about their postacute recovery. In addition, patients expressed a common desire to view their diagnoses, laboratory test results, radiology reports, and procedure notes in language that is patient-friendly. Conclusion:Patients have unmet information needs in the hospital setting. Our findings suggest that for some inpatients and their family members, providing personalized health information through a tablet computer may improve satisfaction, decrease anxiety, increase understanding of their health conditions, and improve safety and quality of care. BackgroundBeing a patient in the hospital is an anxiety-inducing experience. Poor communication and lack of access to information can have detrimental effects on a patient's psychological wellbeing and coping abilities [1][2][3][4][5]. Policymakers [6, 7] and patient advocates [8,9] are increasingly focusing on this problem. This study investigates how an inpatient personal health record (PHR) may help address the information needs of patients and improve their engagement and experience in the hospital.Provision of medical information and education about care can allay a patient's uncertainty and stress [10][11][12][13][14][15]. Further, sharing information has been shown to reduce patient requests for clinicians' time, foster a sense of control and empowerment while promoting self-efficacy and ownership of illness [16][17][18], and lead to increased participation as an informed partner in making health decisions [19][20][21][22]. Previous research suggests that patients want to use PHRs and believe that they will be valuable [23]. Moreover, patients believe that their adherence to treatment regimens will improve if they have the opportunity to read and understand their health information [24,25]. However, patients are not typically given the opportunity to review their health information in the hospital. For example, in a survey of hospitalized patients conducted by Cumbler and colleagues, 90% of respondents said they wanted to review their hospital medication list for accuracy, but only 28% said they were given the opportunity to do so [26]. Without access to a documented care plan, patients ar...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient Experiences Using an Inpatient Personal Health Record

Woollen¹,

Prey²,

Wilcox³

et al. 2016

Appl Clin Inform

View full text Add to dashboard Cite

show abstract

“…Some of the differences between our studies are that the difference in the PAM score was not reported in the O’Leary study and the inpatient engagement portal in our study provided more comprehensive information from the medical record. Pell et al [64] also gave hospitalized patients tablet computers to access test results and active medication schedules. In this study, they asked patients and clinicians before and after administering the tablet about perceived beliefs of sharing information with patients.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, they asked patients and clinicians before and after administering the tablet about perceived beliefs of sharing information with patients. They found that the concerns patients and clinicians had about sharing information did not bear out, there was not an increased workload for clinicians and it did not increase confusion or worry by patients [65]. In the inpatient pediatric setting, parental engagement was studied by Palma et al [66] by providing parents of children in the neonatal intensive care unit with a daily, printed care plan.…”

Section: Discussionmentioning

confidence: 99%

Engaging hospitalized patients in clinical care: Study protocol for a pragmatic randomized controlled trial

Creber

Prey

Ryan

et al. 2016

Contemporary Clinical Trials

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Background Patients who are better informed and more engaged in their health care have higher satisfaction with health care and better health outcomes. While patient engagement has been a focus in the outpatient setting, strategies to engage inpatients in their care have not been well studied. We are undertaking a study to assess how patients’ information needs during hospitalization can be addressed with health information technologies. To achieve this aim, we developed a personalized inpatient portal that allows patients to see who is on their care team, monitor their vital signs, review medications being administered, review current and historical lab and test results, confirm allergies, document pain scores and send questions and comments to inpatient care providers. The purpose of this paper is to describe the protocol for the study. Methods/design This pragmatic randomized controlled trial will enroll 426 inpatient cardiology patients at an urban academic medical center into one of three arms receiving: 1) usual care, 2) iPad with general internet access, or 3) iPad with access to the personalized inpatient portal. The primary outcome of this trial is patient engagement, which is measured through the Patient Activation Measure. To assess scalability and potential reach of the intervention, we are partnering with a West Coast community hospital to deploy the patient engagement technology in their environment with an additional 160 participants. Conclusion This study employs a pragmatic randomized control trial design to test whether a personalized inpatient portal will improve patient engagement. If the study is successful, continuing advances in mobile computing technology should make these types of interventions available in a variety of clinical care delivery settings.

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“…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.…”

mentioning

confidence: 99%

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

Kelly

Thurber²,

Coller³

et al. 2019

Hospital Pediatrics

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A B S T R A C TBACKGROUND AND OBJECTIVES: Engaging with parents in care improves pediatric care quality and patient safety; however, parents of hospitalized children often lack the information necessary to effectively participate. To enhance engagement, some hospitals now provide parents with real-time online access to information from their child's inpatient medical record during hospitalization. Whether these "inpatient portals" provide benefits for parents of hospitalized children is unknown. Our objectives were to identify why parents used an inpatient portal application on a tablet computer during their child's hospitalization and identify their perspectives of ways to optimize the technology.METHODS: Semistructured in-person interviews were conducted with 14 parents who were given a tablet computer with a commercially available inpatient portal application for use throughout their child's hospitalization. The portal included vital signs, diagnoses, medications, laboratory test results, patients' schedule, messaging, education, and provider pictures and/or roles. Interviews were audio recorded and transcribed and continued until reaching thematic saturation. Three researchers used an inductive approach to identify emergent themes regarding why parents used the portal. RESULTS:Five themes emerged regarding parent motivations for accessing information within the portal: (1) monitoring progress, (2) feeling empowered and/or relying less on staff, (3) facilitating rounding communication and/or decision-making, (4) ensuring information accuracy and/or providing reassurance, and (5) aiding memory. Parents recommended that the hospital continue to offer the portal and expand it to allow parents to answer admission questions, provide feedback, and access doctors' daily notes.CONCLUSIONS: Providing parents with real-time clinical information during their child's hospitalization using an inpatient portal may enhance their ability to engage in caregiving tasks critical to ensuring inpatient care quality and safety.

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Patient Access to Electronic Health Records During Hospitalization

Cited by 40 publications

References 4 publications

Patient Experiences Using an Inpatient Personal Health Record

Patient Experiences Using an Inpatient Personal Health Record

Engaging hospitalized patients in clinical care: Study protocol for a pragmatic randomized controlled trial

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

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