Nambisan Priya
Associate Professor Department of Health Informatics and Administration College of Health Sciences University of Wisconsin - Milwaukee Northwest Quadrant Building B, Rm #6410 2400 East Hartford Avenue, Milwaukee, WI 53201-0413, United States.
Int J Med Inform. 2017 Jun;102:62-70. doi: 10.1016/j.ijmedinf.2017.03.004. Epub 2017 Mar 10.
Healthcare organizations in the US are increasingly using Patient Portals as a means to provide patients with partial access to their health records and thereby comply with the 'meaningful use' of Health Information Technology policy issued by the US federal government. Patient portals are used to not only provide access to parts of the health records such as lab results but also offer services such as customized educational materials and appointment scheduling. While prior studies examining the adoption rates of these patient portals have not offered consistent findings, many of the studies have reported limited adoption and use [1] of patient portals, especially among the underserved population. This study explores the factors behind the reduced adoption rate of patient portals among the underserved by focusing on their Patient Web Portal Readiness (PWPR).
The study empirically evaluates the impact of three important variables on PWPR among the underserved: (a) Personal Health Information Management (PHIM) activities, (b) patient attitude toward personal health record keeping; and (c) use of Internet for health information seeking. The study also incorporates three other factors: (d) access to Internet; (e) demographics; and (f) presence of chronic illness.
Data were collected through a survey from 132 patients from the underserved population who visited 5 free clinics in the Northern Virginia area in the US. The paper-based survey was administered to the patients who visited these free clinics for care.
The study findings show support for the hypotheses related to the impact of the two key factors - Personal Health Information Management (PHIM) activities and attitude toward personal health record keeping - on PWPR. The findings also indicate that the use of Internet for health information seeking has relatively more impact than patient's Internet access on PWPR. Overall, the findings imply the critical importance of complementary activities - e.g., PHIM activities, Internet-based health information seeking - to enhance PWPR among the underserved population.
美国的医疗保健机构越来越多地使用患者门户网站,以此为患者提供部分健康记录访问权限,从而符合美国联邦政府发布的健康信息技术政策中的“有意义使用”要求。患者门户网站不仅用于提供对部分健康记录(如实验室检查结果)的访问,还提供定制化教育材料和预约安排等服务。虽然之前关于这些患者门户网站采用率的研究结果并不一致,但许多研究报告称患者门户网站的采用和使用情况有限[1],尤其是在服务不足人群中。本研究通过关注患者的网络门户准备度(PWPR),探讨服务不足人群中患者门户网站采用率降低背后的因素。
该研究实证评估了三个重要变量对服务不足人群PWPR的影响:(a)个人健康信息管理(PHIM)活动;(b)患者对个人健康记录保存的态度;以及(c)利用互联网获取健康信息。该研究还纳入了其他三个因素:(d)互联网接入情况;(e)人口统计学特征;以及(f)慢性病患病情况。
通过对美国弗吉尼亚州北部地区5家免费诊所的132名服务不足人群患者进行调查收集数据。纸质调查问卷发放给前往这些免费诊所就诊的患者。
研究结果支持了与两个关键因素——个人健康信息管理(PHIM)活动和对个人健康记录保存的态度——对PWPR影响相关的假设。研究结果还表明,利用互联网获取健康信息对PWPR的影响相对大于患者的互联网接入情况。总体而言,研究结果表明互补活动(如PHIM活动、基于互联网的健康信息获取)对于提高服务不足人群的PWPR至关重要。