The Promise of Patient Portals for Individuals Living With Chronic Illness: Qualitative Study Identifying Pathways of Patient Engagement.

Autor: Stewart MT; Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States.; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States., Hogan TP; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States., Nicklas J; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States., Robinson SA; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.; Department of Medicine, Boston University School of Medicine, Boston, MA, United States., Purington CM; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States., Miller CJ; Center for Healthcare Organization and Implementation Research, Boston VA Healthcare System, Boston, MA, United States.; Department of Psychiatry, Harvard Medical School, Boston, MA, United States., Vimalananda VG; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.; Department of Medicine, Boston University School of Medicine, Boston, MA, United States., Connolly SL; Center for Healthcare Organization and Implementation Research, Boston VA Healthcare System, Boston, MA, United States.; Department of Psychiatry, Harvard Medical School, Boston, MA, United States., Wolfe HL; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.; Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States., Nazi KM; Independent Consultant, Coxsackie, NY, United States., Netherton D; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.; Division of Biostatistics and Health Services Research, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States., Shimada SL; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.; Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, United States.; Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.
Jazyk: angličtina
Zdroj: Journal of medical Internet research [J Med Internet Res] 2020 Jul 17; Vol. 22 (7), pp. e17744. Date of Electronic Publication: 2020 Jul 17.
DOI: 10.2196/17744
Abstrakt: Background: Patients play a critical role in managing their health, especially in the context of chronic conditions like diabetes. Electronic patient portals have been identified as a potential means to improve patient engagement; that is, patients' involvement in their care. However, little is known about the pathways through which portals may help patients engage in their care.
Objective: Our objective is to understand how an electronic patient portal facilitates patient engagement among individuals with diabetes.
Methods: This qualitative study employed semistructured telephone interviews of 40 patients living with diabetes since at least 2011, who had experienced uncontrolled diabetes, and had used secure messaging through a portal at least 4 times over 18 months. The interviews were recorded, transcribed, coded, and analyzed using primarily an inductive approach to identify how patients living with diabetes use an online health portal to support diabetes self-management.
Results: Overall, patients who used the portal reported feeling engaged in their health care. We identified four pathways by which the portal facilitates patient engagement and some challenges. The portal provides a platform that patients use to (1) better understand their health by asking questions about new symptoms, notes, or labs, (2) prepare for medical appointments by reviewing labs and notes, (3) coordinate care between VA (Veterans Affairs) and non-VA health care teams, and (4) reach out to providers to request help between visits. Several patients reported that the portal helped improve the patient-provider relationship; however, aspects of the portal design may hinder engagement for others. Patients reported challenges with both secure messaging and access to medical records that had negative impacts on their engagement. Benefits for patient engagement were described by many types of portal users with varying degrees of diabetes control.
Conclusions: Patient portals support engagement by facilitating patient access to their health information and by facilitating patient-provider communication. Portals can help a wide range of users engage with their care.
(©Maureen T Stewart, Timothy P Hogan, Jeff Nicklas, Stephanie A Robinson, Carolyn M Purington, Christopher J Miller, Varsha G Vimalananda, Samantha L Connolly, Hill L Wolfe, Kim M Nazi, Dane Netherton, Stephanie L Shimada. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.07.2020.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje