Kelly Michelle M, Dean Shannon M, Carayon Pascale, Wetterneck Tosha B, Hoonakker Peter L T
Michelle M. Kelly, MD, H4/419 CSC, 600 Highland Ave., Madison, WI 53792, USA, Phone: (608) 265-5545, Fax: (608) 265-8074, Email:
Appl Clin Inform. 2017 Mar 15;8(1):265-278. doi: 10.4338/ACI-2016-11-RA-0194.
Patient electronic health record (EHR) portals can enhance patient and family engagement by providing information and a way to communicate with their healthcare team (HCT). However, portal implementation has been limited to ambulatory settings and met with resistance from HCTs.
We evaluated HCT perceptions before and 6-months after implementation of an inpatient EHR portal application on a tablet computer given to parents of hospitalized children.
This repeated cross-sectional study was conducted with HCT members (nurses, physicians, ancillary staff) on a medical/surgical unit at a quaternary children's hospital. From December 2014-June 2015, parents of children <12 years old were given a portal application on a tablet computer. It provided real-time vitals, medications, lab results, schedules, education, HCT information and a way to send the HCT messages/requests. HCT members completed surveys pre- and post-implementation regarding their portal perceptions. Pre-post differences in HCT perceptions were compared using chi-squared, Mann-Whitney and Kruskall Wallis tests.
Pre-implementation, HCT respondents (N=94) were generally optimistic about the benefits of a portal for parents; however, all anticipated challenges to portal use. Over the next 6-months, 296 parents used the portal, sending 176 requests and 36 messages. Post-implementation, HCT respondent (N=70) perceptions of these challenges were significantly reduced (all p<0.001), including: parents (will) have too many questions (69 vs. 3%, pre-post), parents (will) know results before the HCT (65 vs. 1%), staff (would be/are) skeptical (43 vs. 21%) and there (will be/is) not enough technical support (28 vs. 1%).
All HCT respondents anticipated challenges in providing a portal to parents of hospitalized children; however, these concerns were minimized after implementation.
患者电子健康记录（EHR）门户可以通过提供信息以及与医疗团队（HCT）沟通的方式来增强患者及其家属的参与度。然而，门户的实施仅限于门诊环境，并且遭到了医疗团队的抵制。
我们评估了在向住院儿童的父母发放平板电脑以应用住院患者EHR门户之前及实施6个月后医疗团队的看法。
这项重复横断面研究是在一家四级儿童医院的内科/外科病房中对医疗团队成员（护士、医生、辅助人员）开展的。2014年12月至2015年6月期间，为12岁以下儿童的父母发放了平板电脑上的门户应用程序。它提供实时生命体征、用药情况、实验室检查结果、日程安排、教育内容、医疗团队信息以及向医疗团队发送消息/请求的方式。医疗团队成员在实施前后完成了关于他们对门户看法的调查。使用卡方检验、曼-惠特尼检验和克鲁斯卡尔-沃利斯检验比较医疗团队看法的前后差异。
在实施之前，医疗团队受访者（N = 94）总体上对门户给父母带来的益处持乐观态度；然而，所有人都预计到了门户使用方面的挑战。在接下来的6个月里，296名父母使用了该门户，发送了176条请求和36条消息。实施之后，医疗团队受访者（N = 70）对这些挑战的看法显著减少（所有p < 0.001），包括：父母（会）有太多问题（从实施前的69%降至实施后的3%）、父母（会）在医疗团队之前知晓结果（从65%降至1%）、工作人员（会）持怀疑态度（从43%降至21%）以及（会）没有足够的技术支持（从28%降至1%）。
所有医疗团队受访者都预计到向住院儿童的父母提供门户会面临挑战；然而，在实施之后这些担忧得到了缓解。
