Using tethered-personal health records for pre-liminary end-of-life discussions with medical providers: Preferences of African American vs. Caucasian primary care patients

Bose‐Brill, Seuli; Kretovics, Matthew; Ballenger, Taylor; Modan, Gabriella; Lai, Albert M.; Belanger, Lindsay; Koesters, Stephen; Curtis, J. Randall; Wills, Celia E.

doi:10.5430/cns.v2n2p133

Cited by 6 publications

(2 citation statements)

References 43 publications

(52 reference statements)

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“…It is important to note that many of the unaddressed problems highlighted in previous literature reviews are likely to still be problems despite being out of the scope of this review. For instance, many prior studies have cited usability issues with portals, 124,[152][153][154][155][156][157][158][159][160][161][162][163] but it was not a major finding in our review. This does not mean that problems such as inconsistency across platforms are not still issues, especially considering that a recent survey of U.S. adults found that 44% of those with a portal account were managing two or more accounts.…”

Section: Limitationsmentioning

confidence: 85%

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

Reynolds,

Cobb,

Steitz

et al. 2023

Appl Clin Inform

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Background and Objective Recent external factors—the 21st Century Cures Act and the coronavirus disease 2019 (COVID-19) pandemic—have stimulated major changes in the patient portal landscape. The objective of this state-of-the-art review is to describe recent developments in the patient portal literature and to identify recommendations and future directions for the design, implementation, and evaluation of portals. Methods To focus this review on salient contemporary issues, we elected to center it on four topics: (1) 21st Century Cures Act's impact on patient portals (e.g., Open Notes); (2) COVID-19's pandemic impact on portals; (3) proxy access to portals; and (4) disparities in portal adoption and use. We conducted targeted PubMed searches to identify recent empirical studies addressing these topics, used a two-part screening process to determine relevance, and conducted thematic analyses. Results Our search identified 174 unique papers, 74 were relevant empirical studies and included in this review. Among these papers, we identified 10 themes within our four a priori topics, including preparing for and understanding the consequences of increased patient access to their electronic health information (Cures Act); developing, deploying, and evaluating new virtual care processes (COVID-19); understanding current barriers to formal proxy use (proxy access); and addressing disparities in portal adoption and use (disparities). Conclusion Our results suggest that the recent trends toward understanding the implications of immediate access to most test results, exploring ways to close gaps in portal adoption and use among different sub-populations, and finding ways to leverage portals to improve health and health care are the next steps in the maturation of patient portals and are key areas that require more research. It is important that health care organizations share their innovative portal efforts, so that successful measures can be tested in other contexts, and progress can continue.

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Section: Limitationsmentioning

confidence: 85%

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

Reynolds,

Cobb,

Steitz

et al. 2023

Appl Clin Inform

View full text Add to dashboard Cite

show abstract

“…Expanded use of patient portals linked to electronic health records (EHRs) has increased individuals' involvement in disease self‐management and engagement with providers. A patient portal can be a vehicle for efficient, quality ACP communication, but age‐based willingness of individuals to use patient portals for ACP communication must be assessed …”

mentioning

confidence: 99%

Factors Associated with Age Affect Willingness to Engage in Early End‐of‐Life Communication Using Electronic Health Record–Tethered Patient Portals

Bose‐Brill

Kobe

Kretovics

et al. 2016

J American Geriatrics Society

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Patient Portals to Support Palliative and End-of-Life Care: Scoping Review

Ingle¹,

Valdovinos²,

Ford³

et al. 2021

J Med Internet Res

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Background Although patient portals are widely used for health promotion, little is known about the use of palliative care and end-of-life (PCEOL) portal tools available for patients and caregivers. Objective This study aims to identify and assess the user perspectives of PCEOL portal tools available to patients and caregivers described and evaluated in the literature. Methods We performed a scoping review of the academic literature directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) extension for Scoping Review and searched three databases. Sources were included if they reported the development or testing of a feature, resource, tool, or intervention; focused on at least one PCEOL domain defined by the National Coalition for Hospice and Palliative Care; targeted adults with serious illness or caregivers; and were offered via a patient portal tethered to an electronic medical record. We independently screened the titles and abstracts (n=796) for eligibility. Full-text (84/796, 10.6%) sources were reviewed. We abstracted descriptions of the portal tool name, content, targeted population, and reported user acceptability for each tool from included sources (n=19). Results In total, 19 articles describing 12 tools were included, addressing the following PCEOL domains: ethical or legal (n=5), physical (n=5), and psychological or psychiatric (n=2). No tools for bereavement or hospice care were identified. Studies have reported high acceptability of tools among users; however, few sources commented on usability among older adults. Conclusions PCEOL patient portal tools are understudied. As medical care increasingly moves toward virtual platforms, future research should investigate the usability and acceptability of PCEOL patient portal resources and evaluate their impact on health outcomes.

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Using tethered-personal health records for pre-liminary end-of-life discussions with medical providers: Preferences of African American vs. Caucasian primary care patients

Cited by 6 publications

References 43 publications

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

Factors Associated with Age Affect Willingness to Engage in Early End‐of‐Life Communication Using Electronic Health Record–Tethered Patient Portals

Patient Portals to Support Palliative and End-of-Life Care: Scoping Review

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