Use of a Patient-Accessible Electronic Medical Record in a Practice for Congestive Heart Failure: Patient and Physician Experiences

Earnest, Mark; Se, Ross; Wittevrongel, Loretta; Moore, Laurie; Lin, Chen-Tan

doi:10.1197/jamia.m1479

Cited by 163 publications

(206 citation statements)

References 14 publications

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“…Although we did not assess the provider burden, the patterns of use suggest that the overwhelming majority of patients are judicious in messaging providers. These findings complement surveys suggesting that providers perceive little change in workload following portal implementation (78,79). Our findings should be interpreted in light of a few limitations.…”

Section: Discussioncontrasting

confidence: 33%

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Jhamb

Cavanaugh

Bian

et al. 2015

Clinical Journal of the American Society of Nephrology

126

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Background and objectives Electronic health record (EHR) patient portals allow individuals to access their medical information with the intent of patient empowerment. However, little is known about portal use in nephrology patients. We addressed this gap by characterizing adoption of an EHR portal, assessing secular trends, and examining the association of portal adoption and BP control (,140/90 mmHg).Design, setting, participants, & measurements Patients seen between January 1, 2010, and December 31, 2012, at any of four university-affiliated nephrology offices who had at least one additional nephrology follow-up visit before June 30, 2013, were included. Sociodemographic characteristics, comorbidities, clinical measurements, and office visits were abstracted from the EHR. Neighborhood median household income was obtained from the American Community Survey 2012.Results Of 2803 patients, 1098 (39%) accessed the portal. Over 87% of users reviewed laboratory results, 85% reviewed their medical information (e.g., medical history), 85% reviewed or altered appointments, 77% reviewed medications, 65% requested medication refills, and 31% requested medical advice from their renal provider. ConclusionWhile portal adoption appears to be increasing, greater attention is needed to understand why vulnerable populations do not access it. Future research should examine barriers to the use of e-health technologies in underserved patients with CKD, interventions to address them, and their potential to improve outcomes.

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Section: Discussioncontrasting

confidence: 33%

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Jhamb

Cavanaugh

Bian

et al. 2015

Clinical Journal of the American Society of Nephrology

126

View full text Add to dashboard Cite

show abstract

“…With the growth of health information technology, small experiments with open records began. [14][15][16] Researchers targeted chronic disease management and found improvements in care plan adherence with the assistance of online medical records. These positive findings encouraged us to mount a larger study.…”

Section: Rootsmentioning

confidence: 99%

Interval Examination: Moving Toward Open Notes

Walker

Delbanco

2013

J GEN INTERN MED

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“…Previous research demonstrated that such systems can be feasible, secure, and well accepted by patients. 6,7,9,11,13,[15][16][17] Laboratory results and e-mail typically have been the most popular features.Fewer systems have been developed specifically for pediatrics. General pediatrics has lagged behind other specialties in uptake of electronic health tools.…”

mentioning

confidence: 99%

“…Nearly all of those systems focused on adult populations in primary care 6-10 or populations with specific chronic illnesses, such as diabetes mellitus 11,12 or heart failure. 13,14 Such systems typically include access to key parts of the EHR, such as laboratory results, medications, and visits. They often allow patients to communicate electronically with providers and to track simple health information.…”

mentioning

confidence: 99%

Pediatric Personal Health Records: Current Trends and Key Challenges

Britto

Wimberg

2009

Pediatrics

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Personal health records may enhance pediatric care and outcomes. Few systems have been developed or customized for pediatrics, and evaluations are scarce. Special considerations in pediatrics include pediatric content such as growth charts, complex privacy and confidentiality considerations, and the changing developmental needs of children and adolescents. Pediatrics 2009;123:S97-S99 P EDIATRICIANS HAVE LONG used tools such as immunization cards and well-child booklets to provide families with access to key information about their children's health. In the past 15 years, electronic records and the Internet have become increasingly important and available mechanisms through which to provide families with data about their children's health and to assist families in tracking their children's health and development. Families also create their own paper and electronic records of their children's health and health care needs. Electronic systems, known as personal health records (PHRs), may play key roles in enhancing partnerships between families and health care providers, promoting self-care, and enhancing family decision-making regarding the health of children and adolescents. Furthermore, they can provide key health information when a child becomes ill away from home or in a disaster. This article reviews PHR types and characteristics, summarizes some existing systems, and describes special challenges for PHRs in pediatrics.PHRs have been defined by the Markle Foundation as an "electronic application through which individuals can access, manage and share their health information, and that of others for whom they are authorized, in a private, secure, and confidential environment." 1 An ideal PHR would be lifelong and would integrate information from many sources, such as health care systems, pharmacies, and insurers, as well as family-entered information such as symptoms, health concerns, and self-monitoring findings. It would be controlled by the patient or family, and it would be private and secure. It would facilitate communication between families and providers, using functions such as secure e-mail. 1 No existing systems meet all of these criteria, partly because of the difficulty of merging data from multiple sources into a single data system. Privacy concerns and lack of a strong business case for PHRs have also hindered their development.In the early 1990s, many commercial vendors developed Internet-based, stand-alone systems. These systems required consumers to enter and to maintain their own health information. Although some of these systems remain, they have never become popular, likely because of the onerous nature of maintaining the information. Therefore, PHRs linked to electronic health records (EHRs) and other sources of health information have become the preferred model. 1,2 Recently, several large software makers announced their plans to develop secure PHRs that could link to physicians ' and hospitals' EHRs. 3,4 Once these systems overcome the technical challenges of integrating informatio...

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Use of a Patient-Accessible Electronic Medical Record in a Practice for Congestive Heart Failure: Patient and Physician Experiences

Abstract: SPPARO was useful for a number of patients. Physicians initially voiced a number of concerns about implementing SPPARO, but their experience with it was far more positive.

Cited by 163 publications

References 14 publications

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Interval Examination: Moving Toward Open Notes

Pediatric Personal Health Records: Current Trends and Key Challenges

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