青少年患者保密门户的有效使用。

Meaningful Use of a Confidential Adolescent Patient Portal.

作者信息

Thompson Lindsay A, Martinko Thomas, Budd Pamela, Mercado Rebeccah, Schentrup Anzeela M

机构信息

Department of Pediatrics, University of Florida, Gainesville, Florida; Department of Health Outcomes and Policy, University of Florida, Gainesville, Florida.

Adolescent Medicine, Department of Pediatrics, University of Florida, Gainesville, Florida.

出版信息

J Adolesc Health. 2016 Feb;58(2):134-40. doi: 10.1016/j.jadohealth.2015.10.015.

DOI:10.1016/j.jadohealth.2015.10.015

PMID:26802988

Abstract

PURPOSE

To design and evaluate the usage of an adolescent patient portal specifically adapted for adolescent health care needs that also satisfied institutional meaningful use guidelines regarding electronic health records.

METHODS

Key stakeholders at one academic health care center adopted an online portal and opted to designate a patient portal specifically for adolescents to maximize confidentiality in compliance with state privacy laws. This study analyzed aggregate electronic health record data of adolescents' (ages 12-17.9 years) uptake, usage, and functionality of this portal and compared it to parent portal usage for younger children (ages 0-11 years). Differences in means were calculated using paired t tests.

RESULTS

The portal was used similarly between parents of young children and adolescents, with almost 1,000 enrollees in each group from September 1, 2012 to March 31, 2015. There were no gender differences in enrollment. Adolescents were less likely than parents of younger children to review appointments (73% vs. 85%), laboratory tests (67% vs. 79%), problem lists (40% vs. 78%), or allergies (45% vs. 77%, all p values <.001). Parents of younger children more frequently messaged providers (3,297 messages) although adolescents sent 1,397 confidential messages.

CONCLUSIONS

Institutional decisions for implementing meaningful use requirements can align with goals of adolescent health. Patient portals can enhance adolescent health care quality and adolescents readily use a confidential portal. Implementation of meaningful use requirements should be checked against adolescent health care needs to maximize confidentiality and promote health communication.

摘要

目的

设计并评估一款专门针对青少年医疗保健需求的青少年患者门户的使用情况，该门户还需符合机构关于电子健康记录的有意义使用指南。

方法

一家学术医疗中心的关键利益相关者采用了一个在线门户，并选择专门为青少年指定一个患者门户，以根据州隐私法最大限度地保护隐私。本研究分析了青少年（12至17.9岁）对该门户的使用情况、功能以及汇总的电子健康记录数据，并将其与年幼儿童（0至11岁）的家长门户使用情况进行比较。使用配对t检验计算均值差异。

结果

年幼儿童的家长和青少年对该门户的使用情况相似，从2012年9月1日至2015年3月31日，每组登记人数近1000人。登记情况无性别差异。青少年查看预约（73%对85%）、实验室检查结果（67%对79%）、问题列表（40%对78%）或过敏信息（45%对77%，所有p值<0.001）的可能性低于年幼儿童的家长。年幼儿童的家长向医疗服务提供者发送的信息更频繁（3297条信息），尽管青少年发送了1397条保密信息。