van der Vaart Rosalie, Drossaert Constance H C, Taal Erik, Drossaers-Bakker K Wiepke, Vonkeman Harald E, van de Laar Mart A F J
Department of Psychology, Health & Technology, University of Twente, Citadel H423, P,O, Box 217 7500 AE, Enschede, The Netherlands.
BMC Musculoskelet Disord. 2014 Mar 26;15:102. doi: 10.1186/1471-2474-15-102.
To measure the use, satisfaction and impact of a web portal which provides patients with rheumatoid arthritis home access to their electronic medical records (EMR).
A pretest-posttest study was conducted among 360 patients. Questionnaires assessed socio-demographics, health literacy, Internet use, disease characteristics, patient-provider relationship and empowerment before and after launching a hospital-based patient web portal. To measure the impact of the portal, patients' satisfaction with care, trust in their rheumatologist, self-efficacy in patient-provider communication, illness perceptions, and medication adherence were assessed. The post-test included questions on portal use, satisfaction, and self-perceived impact due to portal use.
54% of respondents with Internet access had viewed their EMR. Respondents were positive about the ease of use and usefulness of the portal and reported very few problems. Age (P = .03), amount of Internet use (P = .01) and self-perceived Internet skills (P = .03) significantly predicted portal use. Of the respondents who had logged in, 44% reported feeling more involved in their treatment and 37% felt they had more knowledge about their treatment. Significant differences over time were not found on the empowerment-related instruments.
The current portal succeeded in offering patients access to their EMR in a usable and understandable way. While its true impact is difficult to grasp, a relevant portion of the patients felt more involved in their treatment due to the web portal. Offering patients home EMR access, therefore, appears to be a valuable addition to the care process.
评估一个为类风湿关节炎患者提供在家访问其电子病历（EMR）的门户网站的使用情况、满意度及影响。
对360名患者进行了一项前后测研究。在启动基于医院的患者门户网站之前和之后，通过问卷评估社会人口统计学、健康素养、互联网使用情况、疾病特征、医患关系及赋权情况。为衡量该门户网站的影响，评估了患者对医疗护理的满意度、对其风湿病医生的信任度、医患沟通中的自我效能感、疾病认知及药物依从性。后测包括有关门户网站使用、满意度以及因使用门户网站而产生的自我认知影响的问题。
54%有互联网接入的受访者查看了他们的电子病历。受访者对该门户网站的易用性和实用性持积极态度，且报告的问题很少。年龄（P = 0.03）、互联网使用量（P = 0.01）和自我感知的互联网技能（P = 0.03）显著预测了门户网站的使用情况。在已登录的受访者中，44%报告感觉更多地参与到了自己的治疗中，37%感觉他们对自己的治疗有了更多了解。在与赋权相关的工具上未发现随时间的显著差异。
当前的门户网站成功地以一种可用且易懂的方式为患者提供了访问其电子病历的途径。虽然其真正的影响难以把握，但相当一部分患者因该门户网站而感觉更多地参与到了自己的治疗中。因此，为患者提供在家访问电子病历的途径似乎是护理过程中有价值的补充。
