Patient activation and use of an electronic patient portal

Ancker, Jessica S.; Osorio, Snezana Nena; Cheriff, Adam D.; Cole, Curtis L.; Silver, Michael; Kaushal, Rainu

doi:10.3109/17538157.2014.908200

Cited by 69 publications

(58 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study examining the effects of patient portals on patient activation in acute care settings showed no association between patient activation and use of the patient portal [20]. In our study, patient activation, assessed by the overall MHRM score, increased over the follow-up period suggesting that engagement with the patient portal increased activation.…”

Section: Discussioncontrasting

confidence: 51%

A Web-Based Patient Portal for Mental Health Care: Benefits Evaluation

et al. 2016

View full text Add to dashboard Cite

BackgroundTreatment for mental illness has shifted from focusing purely on treatment of symptoms to focusing on personal recovery. Patient activation is an important component of the recovery journey. Patient portals have shown promise to increase activation in primary and acute care settings, but the benefits to tertiary level mental health care remain unknown.ObjectiveTo conduct a benefits evaluation of a Web-based portal for patients undergoing treatment for serious or persistent mental illness in order to examine the effects on (1) patient activation, (2) recovery, (3) productivity, and (4) administrative efficiencies.MethodsAll registered inpatients and outpatients at a tertiary level mental health care facility were offered the opportunity to enroll and utilize the patient portal. Those who chose to use the portal and those who did not were designated as “users” and “nonusers,” respectively. All patients received usual treatment. Users had Web-based access to view parts of their electronic medical record, view upcoming appointments, and communicate with their health care provider. Users could attend portal training or support sessions led by either the engagement coordinator or peer support specialists. A subset of patients who created and utilized their portal account completed 2 Web-based surveys at baseline (just after enrollment; n=91) and at follow-up (6 and 10 months; n=65). The total score of the Mental Health Recovery Measure (MHRM) was a proxy for patient activation and the individual domains measured recovery. The System and Use Survey Tool (SUS) examined the use of functions and general feedback about the portal. Organizational efficiencies were evaluated by examining the odds of portal users and nonusers missing appointments (productivity) or requesting information from health information management (administrative efficiencies) in the year before (2014) and the year after (2015) portal implementation.ResultsA total of 461 patients (44.0% male, n=203) registered for the portal, which was used 4761 times over the 1-year follow-up period. The majority of uses (95.34%, 4539/4761) were for e-views. The overall MHRM score increased from 70.4 (SD 23.6) at baseline to 81.7 (SD 25.1) at combined follow-up (P=.01). Of the 8 recovery domains, 7 were increased at follow-up (all P<.05). The odds of a portal user attending an appointment were 67% (CI 56%-79%) greater than that of nonusers over the follow-up period. Compared with 2014, over 2015 there was an 86% and 57% decrease in requests for information in users and nonusers, respectively. The SUS revealed that users felt an increased sense of autonomy and found the portal to be user-friendly, helpful, and efficient but felt that more information should be accessible.ConclusionsThe benefits evaluation suggested that access to personal health records via patient portals may improve patient activation, recovery scores, and organizational efficiencies in a tertiary level mental health care facility.

show abstract

Section: Discussioncontrasting

confidence: 51%

A Web-Based Patient Portal for Mental Health Care: Benefits Evaluation

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Indeed, the few studies emerging on the efficacy of online support tools have generally shown strong clinical effects on patient engagement and outcomes [52-55]. One recent investigation examined patient activation and utilization of ePHRs via a telephone survey and found no difference in patient activation; however, these individuals were not necessarily managing MCC nor were they recently diagnosed with a new condition, both of which could affect usage [57]. …”

Section: Discussionmentioning

confidence: 99%

Access to Electronic Personal Health Records Among Patients With Multiple Chronic Conditions: A Secondary Data Analysis

Greenberg¹,

Falisi²,

Rutten³

et al. 2017

J Med Internet Res

View full text Add to dashboard Cite

BackgroundIn the United States, national incentives for offering access to electronic personal health records (ePHRs) through electronic means are geared toward creating a culture of patient engagement. One group of patients who stand to benefit from online access to ePHRs is the growing population with multiple chronic conditions (MCC). However, little is known about the current availability and use of ePHRs and patient portals among those managing MCC.ObjectiveThe aim was to determine the associations between number of chronic conditions and sociodemographic characteristics and usage of ePHRs, and to assess how the public’s use of ePHRs varies across subpopulations, including those with MCC.MethodsThis study used data collected from the 2014 Health Information National Trends Survey (HINTS), and assessed differences in use of ePHRs between those with and without MCC (N=3497) using multiple logistic regression techniques. Variables associated with health care systems (insurance status, having a regular provider) and patient-reported self-efficacy were included in the statistical models.ResultsThose with MCC (n=1555) had significantly higher odds of accessing their records three or more times in the past year compared to those reporting no chronic conditions (n=1050; OR 2.46, 95% CI 1.37-4.45), but the overall percentage of those with MCC using ePHRs remained low (371 of 1529 item respondents, 25.63% weighted). No difference in odds of accessing their records was found between those reporting one chronic condition (n=892) and those reporting none (n=1050; OR 1.02, 95% CI 0.66-1.58). Significant differences in odds of accessing ePHRs were seen between income and age groups (P<.001 and P=.05, respectively), and by whether respondents had a regular provider (P=.03).ConclusionsWe conclude that ePHRs provide a unique opportunity to enhance MCC patient self-management, but additional effort is needed to ensure that these patients are able to access their ePHRs. An increase in availability of patient access to their ePHRs may provide an opportunity to increase patient engagement and support self-management for all patients and especially those with MCC.

show abstract

“…Our results are comparable to those from a study performed by Ancker et al, who found that patients using a PHR (n ¼ 180) were not more highly activated than nonusers, but were more educated and more likely to use the Internet. 31 Similarly, Wagner et al studied the use of PHRs to promote self-health management in hypertensive patients and found that the use of PHRs did not increase patient activation. 32 …”

Section: Discussionmentioning

confidence: 99%

The Use of Electronic Personal Health Records to Improve Medication Adherence and Patient Engagement: A Randomized Study of Non-valvular Atrial Fibrillation Patients

Chen¹,

Roebuck²,

Sami³

et al. 2017

J Innov Cardiac Rhythm Manage

View full text Add to dashboard Cite

ABSTRACT. Embolic stroke is a major complication of atrial fibrillation (AF) that frequently results in disability or death. The administration of oral anticoagulation can reduce stroke risk in AF patients; however, medication non-adherence can eliminate this benefit. To date, reported patient adherence rates to oral anticoagulation regimens vary. The objective of the current study was to examine the impact of medication-specific education delivered via a personal health record (PHR) system on medication adherence. A randomized, prospective study was conducted from February 2014 to June 2014 at Parkview Health, a not-for-profit, community-based health care clinic that serves a northeastern Indiana population of more than 820,000. AF patients receiving dabigatran (Pradaxa s ; Boehringer Ingelheim GmbH, Ingelheim am Rhein, Germany) to prevent stroke participated in this study. The study participants were predominantly Caucasian males over 65 years of age who were educated, insured, and living above the poverty level. Patients were allowed to view online, download, and transmit health information via a PHR. The intervention group received PHR training and dabigatran education via the PHR. The control group received standard care and PHR access without training. A longitudinal survey pertaining to medication knowledge, medication adherence, and patient engagement was administered at baseline and at the end of the study. Medication-dispensing data collected from pharmacy refill prescriptions were used for calculating the medication possession ratio (MPR). Ninety patients were included in this study, and were randomly assigned to either the intervention group (n ¼ 46) or the control group (n ¼ 44). All participants completed the baseline survey, and 95.6% of patients finished the follow-up survey. The mean score for knowledge increased significantly in the intervention group (from 3.77 to 4.23, p ¼ 0.005), but not in the control group (from 3.70 to 3.95, p ¼ 0.72). The MPR was significantly higher in the intervention group (97.47% vs. 87.67%, p ¼ 0.001). Both groups had similar levels of improvement in Patient Activation Measure scores (from 63.0 to 65.8, p ¼ 0.078 vs. from 63.1 to 63.6, p ¼ 0.814). Patients who used the PHR achieved greater medication knowledge, resulting in improved medication adherence. To our knowledge, no published randomized trial has reported on the use of PHRs to improve medication adherence and knowledge. This study is the first to demonstrate a positive impact on anticoagulation adherence with PHR use.

show abstract

Patient activation and use of an electronic patient portal

Abstract: Patients who chose to use an electronic patient portal were not more highly activated than nonusers, although they were more educated and more likely to be Internet users.

Cited by 69 publications

References 14 publications

A Web-Based Patient Portal for Mental Health Care: Benefits Evaluation

A Web-Based Patient Portal for Mental Health Care: Benefits Evaluation

Access to Electronic Personal Health Records Among Patients With Multiple Chronic Conditions: A Secondary Data Analysis

The Use of Electronic Personal Health Records to Improve Medication Adherence and Patient Engagement: A Randomized Study of Non-valvular Atrial Fibrillation Patients

Contact Info

Product

Resources

About