Keplinger Lynn E, Koopman Richelle J, Mehr David R, Kruse Robin L, Wakefield Douglas S, Wakefield Bonnie J, Canfield Shannon M
Department of Internal Medicine, University of Missouri-Columbia, Columbia, MO 65212, USA.
Fam Med. 2013 May;45(5):335-40.
Electronic patient portals are increasingly common, but there is little information regarding attitudes of faculty and residents at academic medical centers toward them.
The primary objective was to investigate attitudes toward electronic patient portals among primary care residents and faculty and changes in faculty attitudes after implementation. The study design included a pre-implementation survey of 39 general internal medicine and family medicine residents and 43 generalist faculty addressing attitudes and expectations of a planned patient portal and also a pre- and post-implementation survey of general internal medicine and family medicine faculty physicians. The survey also addressed email communication with patients.
Prior to portal implementation, residents reported receiving much less e-mail from patients than faculty physicians; 68% and 9% of residents and faculty, respectively, reported no email exchange in a typical month. Residents were less likely to agree with allowing patients to view selected parts of their medical record on-line than faculty physicians (57% and 81%, respectively). Physicians who participated in the portal's pilot implementation had expected workload to increase (64% agreed), but after implementation, 87% of those responding were neutral or disagreed that workload had increased. After implementation, only 33% believed quality of care had improved compared to 55% who had expected it to improve prior to implementation.
Residents and faculty physicians need to be prepared for a changing environment of electronic communication with patients. Some positive and negative expectations of physicians toward enhanced electronic access by patients were not borne out by experience.
电子患者门户网站越来越普遍,但关于学术医疗中心的教员和住院医师对其态度的信息却很少。
主要目的是调查初级保健住院医师和教员对电子患者门户网站的态度,以及实施后教员态度的变化。研究设计包括对39名普通内科和家庭医学住院医师以及43名全科教员进行实施前调查,了解他们对计划中的患者门户网站的态度和期望,还包括对普通内科和家庭医学教员医生进行实施前和实施后调查。该调查还涉及与患者的电子邮件沟通。
在门户网站实施之前,住院医师报告收到患者的电子邮件比教员医生少得多;分别有68%的住院医师和9%的教员报告在典型月份没有电子邮件交流。住院医师比教员医生更不太可能同意允许患者在线查看其病历的选定部分(分别为57%和81%)。参与门户网站试点实施的医生预计工作量会增加(64%表示同意),但实施后,87%的受访者表示工作量增加与否持中立或反对态度。实施后,只有33%的人认为护理质量有所提高,而实施前预计会提高的人占55%。
住院医师和教员医生需要为与患者进行电子通信的不断变化的环境做好准备。医生对患者增强电子访问的一些积极和消极期望并未得到经验的证实。