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van Kessel R, Ranganathan S, Anderson M, McMillan B, Mossialos E. Exploring potential drivers of patient engagement with their health data through digital platforms: A scoping review. Int J Med Inform 2024; 189:105513. [PMID: 38851132 DOI: 10.1016/j.ijmedinf.2024.105513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/11/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Patient engagement when providing patient access to health data results from an interaction between the available tools and individual capabilities. The recent digital advancements of the healthcare field have altered the manifestation and importance of patient engagement. However, a comprehensive assessment of what factors contribute to patient engagement remain absent. In this review article, we synthesised the most frequently discussed factors that can foster patient engagement with their health data. METHODS A scoping review was conducted in MEDLINE, Embase, and Google Scholar. Relevant data were synthesized within 7 layers using a thematic analysis: (1) social and demographic factors, (2) patient ability factors, (3) patient motivation factors, (4) factors related to healthcare professionals' attitudes and skills, (5) health system factors, (6) technological factors, and (7) policy factors. RESULTS We identified 5801 academic and 200 Gy literature records, and included 292 (4.83%) in this review. Overall, 44 factors that can affect patient engagement with their health data were extracted. We extracted 6 social and demographic factors, 6 patient ability factors, 12 patient motivation factors, 7 factors related to healthcare professionals' attitudes and skills, 4 health system factors, 6 technological factors, and 3 policy factors. CONCLUSIONS Improving patient engagement with their health data enables the development of patient-centered healthcare, though it can also exacerbate existing inequities. While expanding patient access to health data is an important step towards fostering shared decision-making in healthcare and subsequently empowering patients, it is important to ensure that these developments reach all sectors of the community.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands; Digital Public Health Task Force, Association of School of Public Health in the European Region (ASPHER), Brussels, Belgium.
| | | | - Michael Anderson
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
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Phelps RE, Buckner EB. Improving Heart Failure Patient Engagement with Mobile Apps Using Nurse Navigators. J Christ Nurs 2024; 41:106-111. [PMID: 38436341 DOI: 10.1097/cnj.0000000000001148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
ABSTRACT Providing high-quality heart failure education through smartphone applications (apps) empowers patients to more successfully manage their disease process outside the hospital setting. The purpose of this project was to evaluate the addition of nurse navigators to increase engagement of newly-diagnosed heart failure patients with the GetWell Loop (GWL) technology program that assists patient learning and monitoring for self-care. Adding navigators increased patient engagement with the GWL over the use of the GWL without navigators.
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Guasti L, Dilaveris P, Mamas MA, Richter D, Christodorescu R, Lumens J, Schuuring MJ, Carugo S, Afilalo J, Ferrini M, Asteggiano R, Cowie MR. Digital health in older adults for the prevention and management of cardiovascular diseases and frailty. A clinical consensus statement from the ESC Council for Cardiology Practice/Taskforce on Geriatric Cardiology, the ESC Digital Health Committee and the ESC Working Group on e-Cardiology. ESC Heart Fail 2022; 9:2808-2822. [PMID: 35818770 DOI: 10.1002/ehf2.14022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/04/2022] [Accepted: 06/03/2022] [Indexed: 12/14/2022] Open
Abstract
Digital health technology is receiving increasing attention in cardiology. The rise of accessibility of digital health tools including wearable technologies and smart phone applications used in medical practice has created a new era in healthcare. The coronavirus pandemic has provided a new impetus for changes in delivering medical assistance across the world. This Consensus document discusses the potential implementation of digital health technology in older adults, suggesting a practical approach to general cardiologists working in an ambulatory outpatient clinic, highlighting the potential benefit and challenges of digital health in older patients with, or at risk of, cardiovascular disease. Advancing age may lead to a progressive loss of independence, to frailty, and to increasing degrees of disability. In geriatric cardiology, digital health technology may serve as an additional tool both in cardiovascular prevention and treatment that may help by (i) supporting self-caring patients with cardiovascular disease to maintain their independence and improve the management of their cardiovascular disease and (ii) improving the prevention, detection, and management of frailty and supporting collaboration with caregivers. Digital health technology has the potential to be useful for every field of cardiology, but notably in an office-based setting with frequent contact with ambulatory older adults who may be pre-frail or frail but who are still able to live at home. Cardiologists and other healthcare professionals should increase their digital health skills and learn how best to apply and integrate new technologies into daily practice and how to engage older people and their caregivers in a tailored programme of care.
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Affiliation(s)
- Luigina Guasti
- University of Insubria - Department of Medicine and Surgery; ASST-settelaghi, Varese, Italy
| | - Polychronis Dilaveris
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK
| | | | | | - Joost Lumens
- CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mark J Schuuring
- Department of Cardiology, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Stefano Carugo
- University of Milan, Cardiology, Policlinico di Milano, Milan, Italy
| | - Jonathan Afilalo
- Division of Experimental Medicine, McGill University; Centre for Clinical Epidemiology, Jewish General Hospital; Division of Cardiology, Jewish General Hospital, McGill University; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Riccardo Asteggiano
- University of Insubria - Department of Medicine and Surgery; ASST-settelaghi, Varese, Italy.,LARC (Laboratorio Analisi e Ricerca Clinica), Turin, Italy
| | - Martin R Cowie
- Royal Brompton Hospital (Guy's& St Thomas' NHS Foundation Trust) & Faculty of Lifesciences & Medicine, King's College London, London, UK
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Zoorob D, Hasbini Y, Chen K, Wangia-Anderson V, Moussa H, Miller B, Brobst D. Ageism in healthcare technology: the older patients’ aspirations for improved online accessibility. JAMIA Open 2022; 5:ooac061. [PMID: 35855421 PMCID: PMC9277451 DOI: 10.1093/jamiaopen/ooac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/25/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To identify concerns, barriers and facilitators impacting the use of patient portals by older patients as well as desired features in future updates. Materials and Methods This is a cross-sectional study consisting of 2 focus group discussions culminating in an anonymous survey administered to women who were 65 years and older receiving urogynecologic care in Northwest Ohio. Results Of the 205 women surveyed (91% response rate), providers and healthcare systems play the primary 2 roles (73% and 69%, respectively) in facilitating patients’ use of patient portal systems and telehealth applications. Barriers to use revolved around technical difficulties (50%), privacy concerns (45%), and cost of technology (24%). The most important features desired were the ability to modify the text size within the application (47%) and an intuitive, simple interface (46%). Additional assistance for navigating technical challenges was suggested, specifically set-up of accounts (36%), saving and sharing information with caregivers (35%), and sign-in and navigation of portals (32%). Conclusion The paucity of age-aligned medical access software and products may lead to worsening of digital exclusion and disparities in healthcare. Portal application developers and healthcare systems must advance efforts that consider the needs of those who may be older when designing patient portals.
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Affiliation(s)
- Dani Zoorob
- Department of Obstetrics and Gynecology, University of Toledo , Toledo, Ohio 43606, USA
| | - Yasmin Hasbini
- Department of Integrative Biosciences, Wayne State University , Detroit, Michigan 48202, USA
| | - Katherine Chen
- Department of Obstetrics and Gynecology, University of Toledo , Toledo, Ohio 43606, USA
| | | | - Hind Moussa
- Department of Obstetrics and Gynecology, ProMedica Health System , Toledo, Ohio 43606, USA
| | - Brian Miller
- Department of Informatics, ProMedica Health System , Toledo, Ohio 43604, USA
| | - Debi Brobst
- Department of Informatics, ProMedica Health System , Toledo, Ohio 43604, USA
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Nguyen OT, Hong YR, Alishahi Tabriz A, Hanna K, Turner K. Prevalence and Factors Associated with Patient-Requested Corrections to the Medical Record through Use of a Patient Portal: Findings from a National Survey. Appl Clin Inform 2022; 13:242-251. [PMID: 35196717 PMCID: PMC8866035 DOI: 10.1055/s-0042-1743236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Providing patients with medical records access is one strategy that health systems can utilize to reduce medical errors. However, how often patients request corrections to their records on a national scale is unknown. OBJECTIVES We aimed to develop population-level estimates of patients who request corrections to their medical records using national-level data. We also identified patient-level correlates of requesting corrections. METHODS We used the 2017 and 2019 Health Information National Trends Survey and examined all patient portal adopters. We applied jackknife replicate weights to develop population-representative estimates of the prevalence of requesting medical record corrections. We conducted a multivariable logistic regression analysis to identify correlates of requesting corrections while controlling for demographic factors, health care utilization patterns, health status, technology/internet use patterns, and year. RESULTS Across 1,657 respondents, 125 (weighted estimate: 6.5%) reported requesting corrections to their medical records. In unadjusted models, greater odds of requesting corrections were observed among patients who reported their race/ethnicity as non-Hispanic black (odds ratio [OR]: 2.20, 95% confidence interval [CI]: 1.10-4.43), had frequent portal visits (OR: 3.92, 95% CI: 1.51-10.23), and had entered data into the portal (OR: 7.51, 95% CI: 4.08-13.81). In adjusted models, we found greater odds of requesting corrections among those who reported frequent portal visits (OR: 3.39, 95% CI: 1.24-9.33) and those who reported entering data into the portal (OR: 6.43, 95% CI: 3.20-12.94). No other significant differences were observed. CONCLUSION Prior to the Information Blocking Final Rule in April 2021, approximately 6.5% of patients requested corrections of errors in their medical records at the national level. Those who reported higher engagement with their health, as proxied by portal visit frequency and entering data into the portal, were more likely to request corrections.
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Affiliation(s)
- Oliver T. Nguyen
- Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, United States,Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States,Address for correspondence Oliver T. Nguyen, MSHI Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute12902 Magnolia Dr, Tampa, FL 32612-9416United States
| | - Young-Rock Hong
- Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida, United States
| | - Amir Alishahi Tabriz
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States,Department of Oncologic Sciences, University of South Florida, Tampa, Florida, United States
| | - Karim Hanna
- Department of Family Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, United States
| | - Kea Turner
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States,Department of Oncologic Sciences, University of South Florida, Tampa, Florida, United States,Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
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Yue H, Mail V, DiSalvo M, Borba C, Piechniczek-Buczek J, Yule AM. Patient Preferences for Patient Portal-Based Telepsychiatry in a Safety Net Hospital Setting During COVID-19: Cross-sectional Study. JMIR Form Res 2022; 6:e33697. [PMID: 34932497 PMCID: PMC8793913 DOI: 10.2196/33697] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/24/2021] [Accepted: 12/07/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Patient portals are a safe and secure way for patients to connect with providers for video-based telepsychiatry and help to overcome the financial and logistical barriers associated with face-to-face mental health care. Due to the COVID-19 pandemic, telepsychiatry has become increasingly important to obtaining mental health care. However, financial and technological barriers, termed the "digital divide," prevent some patients from accessing the technology needed to use telepsychiatry services. OBJECTIVE As an extension to a clinic's outreach project during COVID-19 to improve patient engagement with video-based visits through the hospital's patient portal among adult behavioral health patients at an urban safety net hospital, we aim to assess patient preference for patient portal-based video visits or telephone-only visits and to identify the demographic variables associated with their preference. METHODS Patients in an outpatient psychiatry clinic were contacted by phone, and preference for telepsychiatry by phone or video through a patient portal, as well as device preference for video-based visits, were documented. Patient demographic characteristics were collected from the electronic medical record. RESULTS A total of 128 patients were reached by phone. A total of 79 (61.7%) patients chose video-based visits, and 69.6% (n=55) of these patients preferred to access the patient portal through a smartphone. Older patients were significantly less likely to agree to video-based visits. CONCLUSIONS Among behavioral health patients at a safety net hospital, there was relatively low engagement with video-based visits through the hospital's patient portal, particularly among older adults.
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Affiliation(s)
- Han Yue
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
| | - Victoria Mail
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
| | - Maura DiSalvo
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Christina Borba
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Joanna Piechniczek-Buczek
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Amy M Yule
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
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Ingle MP, Valdovinos C, Ford KL, Zhou S, Bull S, Gornail S, Zhang X, Moore S, Portz J. Patient Portals to Support Palliative and End-of-Life Care: Scoping Review. J Med Internet Res 2021; 23:e28797. [PMID: 34528888 PMCID: PMC8485198 DOI: 10.2196/28797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/02/2021] [Accepted: 07/27/2021] [Indexed: 01/03/2023] Open
Abstract
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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Affiliation(s)
- M Pilar Ingle
- Graduate School of Social Work, University of Denver, Denver, CO, United States
| | - Cristina Valdovinos
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CO, United States
| | - Kelsey L Ford
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Shou Zhou
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Sheana Bull
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Starlynne Gornail
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Xuhong Zhang
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Susan Moore
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Jennifer Portz
- Department of General Internal Medicine, University of Colorado, Aurora, CO, United States
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Son H, Nahm ES, Zhu S, Galik E, Seidl KL, Van de Castle B, Russomanno V. Testing a Model of Patient Portal Use in Adult Patients. J Nurs Scholarsh 2021; 53:143-153. [PMID: 33538401 DOI: 10.1111/jnu.12633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to test a modified version of the Technology Acceptance Model, which describes users' technology adoption, to examine the relations between patient portal use and potential influencing factors in adult patients who have used patient portals. The modified model posits that patient portal use can be explained by attitude and self-efficacy for using patient portals, perceived usefulness and ease of use, data privacy and security concerns, eHealth literacy, education level, and age. DESIGN A cross-sectional anonymous online survey was conducted for adult patients who had used their patient portals in the past 12 months. METHODS Participants were recruited from 20 settings selected in a large integrated health care system. Data from 743 patients were subject to structural equation modeling for model testing. FINDINGS Sixty-eight percent were White and female, with a mean age of 53.1 years (SD = 15.34). Forty-seven percent used patient portals about monthly or more frequently. Scores for perceived usefulness and ease of use of patient portals were relatively high (as measured using the modified Perceived Health Web Site Usability Questionnaire; each item mean, 6.0-6.2; range, 1-7). The final model adequately fit the data (comparative fit index = .983, standardized root mean square residual = .064, root mean square error of approximation = .059). Patient portal self-efficacy and data privacy and security concerns had a direct impact on patient portal use. Perceived usefulness and ease of use, eHealth literacy, education level, and age indirectly influenced patient portal use. CONCLUSIONS This study contributes to expanding a theoretical understanding of adult patients' patient portal use in a real health care environment. Future studies need to include more diverse populations in various settings. CLINICAL RELEVANCE Knowledge gained from this study can be used by technology experts to make patient portals more user friendly and by administrators to implement patient portals more effectively.
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Affiliation(s)
- Hyojin Son
- Graduate, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Eun-Shim Nahm
- Professor, Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- Associate Professor and Statistician, Office of Research and Scholarship, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Elizabeth Galik
- Professor, Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Kristin L Seidl
- Assistant Professor, Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Barbara Van de Castle
- Assistant Professor, Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Vince Russomanno
- Application Manager, E-Health Department, University of Maryland Medical System, Linthicum Heights, MD, USA
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