Irizarry Taya, DeVito Dabbs Annette, Curran Christine R
School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States.
J Med Internet Res. 2015 Jun 23;17(6):e148. doi: 10.2196/jmir.4255.
Patient portals (ie, electronic personal health records tethered to institutional electronic health records) are recognized as a promising mechanism to support greater patient engagement, yet questions remain about how health care leaders, policy makers, and designers can encourage adoption of patient portals and what factors might contribute to sustained utilization.
The purposes of this state of the science review are to (1) present the definition, background, and how current literature addresses the encouragement and support of patient engagement through the patient portal, and (2) provide a summary of future directions for patient portal research and development to meaningfully impact patient engagement.
We reviewed literature from 2006 through 2014 in PubMed, Ovid Medline, and PsycInfo using the search terms "patient portal" OR "personal health record" OR "electronic personal health record". Final inclusion criterion dictated that studies report on the patient experience and/or ways that patients may be supported to make competent health care decisions and act on those decisions using patient portal functionality.
We found 120 studies that met the inclusion criteria. Based on the research questions, explicit and implicit aims of the studies, and related measures addressed, the studies were grouped into five major topics (patient adoption, provider endorsement, health literacy, usability, and utility). We discuss the findings and conclusions of studies that address the five topical areas.
Current research has demonstrated that patients' interest and ability to use patient portals is strongly influenced by personal factors such age, ethnicity, education level, health literacy, health status, and role as a caregiver. Health care delivery factors, mainly provider endorsement and patient portal usability also contribute to patient's ability to engage through and with the patient portal. Future directions of research should focus on identifying specific populations and contextual considerations that would benefit most from a greater degree of patient engagement through a patient portal. Ultimately, adoption by patients and endorsement by providers will come when existing patient portal features align with patients' and providers' information needs and functionality.
患者门户（即与机构电子健康记录相连的电子个人健康记录）被认为是支持患者更多参与的一种有前景的机制，但对于医疗保健领导者、政策制定者和设计者如何鼓励患者采用患者门户以及哪些因素可能有助于持续使用，仍存在疑问。
本科学现状综述的目的是：（1）介绍患者门户的定义、背景以及当前文献如何通过患者门户鼓励和支持患者参与，（2）总结患者门户研究与开发的未来方向，以对患者参与产生有意义的影响。
我们在PubMed、Ovid Medline和PsycInfo中检索了2006年至2014年的文献，检索词为“患者门户”或“个人健康记录”或“电子个人健康记录”。最终纳入标准规定，研究需报告患者体验和/或支持患者利用患者门户功能做出明智医疗决策并据此采取行动的方式。
我们发现120项研究符合纳入标准。根据研究问题、研究的明确和隐含目标以及所涉及的相关措施，这些研究被分为五个主要主题（患者采用、提供者认可、健康素养、可用性和效用）。我们讨论了涉及这五个主题领域的研究结果和结论。
当前研究表明，患者使用患者门户的兴趣和能力受到个人因素的强烈影响，如年龄、种族、教育水平、健康素养、健康状况以及作为照顾者的角色。医疗保健提供因素，主要是提供者认可和患者门户可用性，也有助于患者通过患者门户参与并与之互动的能力。未来的研究方向应集中于确定哪些特定人群和背景因素将从通过患者门户提高患者参与度中获益最大。最终，当现有的患者门户功能与患者和提供者的信息需求及功能相匹配时，患者才会采用，提供者才会认可。
