Patient Portal Use and Experience Among Older Adults: Systematic Review

Sakaguchi-Tang, Dawn K.; Bosold, Alyssa L; Choi, Yong K.; Turner, Anne M.

doi:10.2196/medinform.8092

Cited by 128 publications

(189 citation statements)

References 33 publications

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“…14,16 Despite the high read rate, the relatively lower use of the portal for ACP compared with article-based AD completion and in-person ACP discussions highlights the need for further evaluation of how and why older adults choose to engage in ACP, including through the patient portal. 20 Our early work described perspectives of early adopters of the ACP tools. 21 More than one-third of interviewees were age 60 years and older and had varying perspectives on usability of portal-based tools compared with article ADs, however that analysis was not after an outreach process to raise awareness about the ACP tools.…”

Section: Discussionmentioning

confidence: 99%

Use of an Ambulatory Patient Portal for Advance Care Planning Engagement

et al. 2019

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Background: Primary care clinics need sustainable, population-based approaches to engage patients in advance care planning (ACP). Patient portal-based ACP tools may provide an option for patient engagement. Objective: To increase ACP outcomes by engaging older adults through portal-based ACP tools, including an electronic Medical Durable Power of Attorney (MDPOA) form. Methods: Geriatric clinic pilot of a multi-modal population-based outreach strategy for portal-based ACP tools. Outreach was to patients (n ‫؍‬ 105) who were 65 years and older with an active portal account, no cognitive impairment, and no MDPOA on file. Patients received a motivational message via the portal and, if not read within 2 weeks, a mailed postcard about the portal-based ACP tools. Primary outcome was composite of any ACP action at 1-year including 1) new advance directive (AD) in the electronic health record, 2) use of portal-based ACP tools, or 3) documented ACP discussion with a provider. Results: Sixty-five older adults read the electronic message at 12 months. Seventeen (16%) engaged in at least 1 ACP action. Fourteen of 17 engaged by adding an AD to their record. More patients completed an AD on article or brought a previously completed AD to clinic, compared with choosing to complete an electronic MDPOA via the portal. Conclusions: Brief motivational messages about ACP via a patient portal is feasible and may increase ACP outcomes for older adults in primary care. Future studies should evaluate population-based portal outreach strategies in combination with team-based workflows to enhance patient engagement in ACP.

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Section: Discussionmentioning

confidence: 99%

Use of an Ambulatory Patient Portal for Advance Care Planning Engagement

et al. 2019

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“…For example, older adults may experience difficulties when using technologies such as mobile devices or smartphones [39]. However, there has been a growing interest in the design of technologies, including innovative health technology design for older adults, who often manage complex health conditions and multiple chronic illnesses, to provide better and more sufficient supportive care services [40]. Our study findings demonstrated that older participants (>65) were interested and had a positive attitude toward using the ASyMS device, although a few of them mentioned that they prefer to use the ASyMS on a larger device with larger font size.…”

Section: Discussionmentioning

confidence: 99%

Usability Evaluation of a Mobile Phone–Based System for Remote Monitoring and Management of Chemotherapy-Related Side Effects in Cancer Patients: Mixed-Methods Study

Moradian¹,

Krzyzanowska²,

Maguire³

et al. 2018

JMIR Cancer

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BackgroundAs most chemotherapy is administered in the outpatient setting, patients are required to manage related side effects at home without direct support from health professionals. The Advanced Symptom Management System (ASyMS) has been developed to facilitate the remote monitoring and management of chemotherapy-related toxicity in patients with cancer, using patient-reported outcomes questionnaires and a clinician alerting system.ObjectiveThis study aims to evaluate the usability of the ASyMS, a mobile phone–based technology, from the perspective of Canadian patients with cancer receiving chemotherapy to identify existing design, functionality, and usability issues and elicit their views, experiences, and satisfaction with the ASyMS.MethodsWe used a mixed-method approach to data collection with user-based testing, a think-aloud technique, semistructured interviews, and short answer questionnaires with a purposive sample of 10 patients with cancer. Participants attended usability testing sessions at the Centre for Global eHealth Innovation, University Health Network, and performed specific tasks on the ASyMS device. The test was videorecorded and each task was timed during the test. After the usability sessions, participants completed a posttest questionnaire and participated in a semistructured qualitative interview. A thematic analysis was used to code and categorize the identified issues into themes that summarized the type and frequency of occurrence.ResultsThe thematic analysis generated 3 overarching themes as follows: ASyMS user-friendliness; usefulness of ASyMS (content quality and richness); and intention to use. Results from the posttest questionnaire indicated that 80% (8/10) of participants had great motivation to use the ASyMS, 70% (7/10) had positive perceptions of the successful use of the ASyMS, and all (10/10, 100%) had a positive attitude toward using the ASyMS in the future. Most identified design and functionality issues were related to the navigation of the ASyMS device and a desire for a more attractive design with advanced functionality and features. The main general design recommendations were as follows: enhance the readability of the screen; implement advance options (eg, search option); and support better navigation.ConclusionsThe ASyMS has shown positive perceptions of patients in usability testing and qualitative interviews. An evaluation of the effects of the ASyMS on symptom outcomes in a clinical trial is needed.

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“…Of nine reviews assessing factors that affect patients' adoption of ePHRs and patient portals [i.e. 10,19,25,130,[131][132][133][134], the current review is the only one that differentiated between factors affecting the intention to use, subjectively-measured use, and objectively-measured use.…”

Section: Strengthsmentioning

confidence: 99%

Factors that affect the use of electronic personal health records among patients: A systematic review

Abd‐Alrazaq

Bewick

Farragher

et al. 2019

International Journal of Medical Informatics

101

110

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ReuseThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) licence. This licence only allows you to download this work and share it with others as long as you credit the authors, but you can't change the article in any way or use it commercially. More information and the full terms of the licence here: https://creativecommons.org/licenses/ TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. AbstractBackground: Electronic personal health records (ePHRs) are web-based tools that enable patients to access parts of their medical records and other services. In spite of the potential benefits of using ePHRs, their adoption rates remain very low. The lack of use of ePHRs among patients leads to implementation failures of these systems. Many studies have been conducted to examine the factors that influence patients' use of ePHRs, and they need to be synthesised in a meaningful way.Objective: The current study aimed to systematically review the evidence regarding factors that influence patients' use of ePHRs.Methods: The search included: 42 bibliographic databases (e.g. Medline, Embase, CINHAL, and PsycINFO), hand searching, checking reference lists of the included studies and relevant reviews, contacting experts, and searching two general web engines. Study selection, data extraction, and study quality assessment were carried out by two reviewers independently. The quality of studies was appraised using the Mixed Methods Appraisal Tool. The extracted data were synthesised narratively according to the outcome: intention to use, subjective measures of use, and objective measures of use. The identified factors were categorised into groups based on Or and Karsh's conceptual framework.Results: Of 5225 citations retrieved, 97 studies were relevant to this review. These studies examined more than 150 different factors: 59 related to intention to use, 52 regarding subjectively-measured use, and 105 related to objectively-measured use. The current review was able to draw definitive conclusions regarding the effect of only 18 factors. Of these, only three factors have been investigated in connection with every outcome, which are: perceived usefulness, privacy and security concerns, and internet access. Conclusion: Of the numerous factors examined by the included studies, this review concluded the effect of 18 factors: 13 personal factors (e.g. gender, ethnicity, and income), four humantechnology factors (e.g. perceived usefulness and ease of use), and one organisational factor (facilitating conditions). These factors should be taken into account by stakeholders for the successful implementation of these systems. For example, patients should be assured that the system is secure and no one can access their records without their permission in order to decrease their concerns about the privacy and security. Fur...

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Patient Portal Use and Experience Among Older Adults: Systematic Review

Cited by 128 publications

References 33 publications

Use of an Ambulatory Patient Portal for Advance Care Planning Engagement

Use of an Ambulatory Patient Portal for Advance Care Planning Engagement

Usability Evaluation of a Mobile Phone–Based System for Remote Monitoring and Management of Chemotherapy-Related Side Effects in Cancer Patients: Mixed-Methods Study

Factors that affect the use of electronic personal health records among patients: A systematic review

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