Collins Sarah A, Rozenblum Ronen, Leung Wai Yin, Morrison Constance Rc, Stade Diana L, McNally Kelly, Bourie Patricia Q, Massaro Anthony, Bokser Seth, Dwyer Cindy, Greysen Ryan S, Agarwal Priyanka, Thornton Kevin, Dalal Anuj K
Partners Healthcare System, Wellesley, Massachusetts.
Brigham and Women's Hospital, Boston, Massachusetts.
J Am Med Inform Assoc. 2017 Apr 1;24(e1):e9-e17. doi: 10.1093/jamia/ocw081.
To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation.
Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations.
Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus.
Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest.
Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals.
描述急症护理环境中患者门户网站的当前实践情况及利益相关者的观点。我们的目标是:(1)识别关键特征;(2)认识挑战;(3)了解设计、配置和使用的当前实践;(4)提出调查和创新的新方向。
采用混合方法,包括对领先学术医疗中心的利益相关者进行调查、访谈、焦点小组讨论和实地考察。进行主题分析以形成一个解释模型并提出建议。
对5家机构进行了实地调查。在4次实地考察中进行了30次访谈/焦点小组讨论,共有84名参与者。确定了关于内容与功能、参与度与文化以及访问与安全的10个主题,并据此开发了当前实践的解释模型。关键特征包括临床数据、消息传递、术语表、患者教育、患者个性化和家庭参与工具以及分层显示。通过小组共识确定了4条可操作的建议。
急症护理患者门户网站的设计、开发和实施应考虑:(1)在不同护理环境中提供单一的综合体验;(2)通过个性化工具使患者与临床医生的关系更加人性化;(3)提供公平的访问机会;(4)制定明确的组织使命和战略以实现预期结果。
门户网站应在住院和门诊环境中提供单一的综合体验。核心功能包括促进沟通、使患者个性化以及提供教育的工具,以推进安全、协调和有尊严的以患者为中心的护理。我们的研究结果可用于为与急症护理患者门户网站相关的未来工作制定“路线图”。