Department of Neurology, Section of Demyelinating Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
J Am Med Inform Assoc. 2012 Jan-Feb;19(1):128-33. doi: 10.1136/amiajnl-2011-000177. Epub 2011 May 12.
To evaluate the use of a secure internet portal in an academic Multiple Sclerosis (MS) Center.
Retrospective case-control chart review of 240 patients during the years 2008 and 2009. Patient demographic and clinical information was extracted from our online medical records, and portal use metrics were provided by Information Systems. Descriptive statistics were utilized to explore characteristics of portal users, how the portal is used, and what associations exist between medical resource utilization and active portal use. Logistic regression identified independent patient predictors and barriers to portal use.
Portal users tended to be young professionals with minimal physical disability. The most frequently used portal feature was secure patient-physician messaging. Message content largely consisted of requests for medications or refills in addition to self-reported side effects. Independent predictors and barriers of portal use include the number of medications prescribed by our staff (OR 1.69, p<0.0001), Caucasian ethnicity (OR 5.04, p=0.007), arm and hand disability (OR 0.23, p=0.01), and impaired vision (OR 0.31, p=0.01). Discussion MS patients use the internet in a greater proportion than the general US population, yet physical disability limits their access. Technological adaptations such as voice-activated commands and easy font-size adjustment may help patients overcome these barriers.
Future research should explore the influence of portal technology on healthcare resource utilization and cost. Additional emedicine applications could be linked to the patient portal for disease monitoring and prospective investigation.
评估在学术性多发性硬化症(MS)中心使用安全互联网门户的情况。
对 2008 年和 2009 年期间的 240 名患者进行回顾性病例对照图表回顾。从我们的在线病历中提取患者的人口统计学和临床信息,信息系统提供门户使用指标。利用描述性统计方法探讨门户使用者的特征、门户的使用方式,以及医疗资源利用与主动门户使用之间存在的关联。逻辑回归确定了独立的患者预测因素和使用门户的障碍。
门户使用者倾向于年轻的专业人员,身体残疾程度最小。最常使用的门户功能是安全的医患消息传递。消息内容主要包括请求开处方或续方,以及自我报告的副作用。门户使用的独立预测因素和障碍包括我们的工作人员开的药物数量(OR 1.69,p<0.0001)、白种人种族(OR 5.04,p=0.007)、手臂和手部残疾(OR 0.23,p=0.01)和视力障碍(OR 0.31,p=0.01)。
多发性硬化症患者比一般美国人口更多地使用互联网,但身体残疾限制了他们的访问。技术适应,如语音激活命令和易于调整字体大小,可能有助于患者克服这些障碍。
未来的研究应该探索门户技术对医疗资源利用和成本的影响。可以将其他电子医学应用程序链接到患者门户,以进行疾病监测和前瞻性研究。