Section of Hospital Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Division of Hospital Medicine, University of California San Francisco, San Francisco, CA, USA.
J Am Med Inform Assoc. 2018 Dec 1;25(12):1626-1633. doi: 10.1093/jamia/ocy125.
To test a patient-centered, tablet-based bedside educational intervention in the hospital and to evaluate the efficacy of this intervention to increase patient engagement with their patient portals during hospitalization and after discharge.
We conducted a randomized controlled trial of adult patients admitted to the hospitalist service in one large, academic medical center. All participants were supplied with a tablet computer for 1 day during their inpatient stay and assistance with portal registration and initial login as needed. Additionally, intervention group patients received a focused bedside education to demonstrate key functions of the portal and explain the importance of these functions to their upcoming transition to post-discharge care. Our primary outcomes were proportion of patients who logged into the portal and completed specific tasks after discharge. Secondary outcomes were observed ability to navigate the portal before discharge and self-reported patient satisfaction with bedside tablet use to access the portal.
We enrolled 97 participants (50 intervention; 47 control); overall 57% logged into their portals ≥1 time within 7 days of discharge (58% intervention vs. 55% control). Mean number of logins was higher for the intervention group (3.48 vs. 2.94 control), and mean number of specific portal tasks performed was higher in the intervention group; however, no individual comparison reached statistical significance. Observed ability to login and navigate the portal in the hospital was higher for the intervention group (64% vs. 60% control), but only 1 specific portal task was significant (view provider messaging tab: 92% vs. 77% control, P = .04). Time needed to deliver the intervention was brief (<15 min for 80%), and satisfaction with the bedside tablet to access the portal was high in the intervention group (88% satisfied/very satisfied).
Our intervention was highly feasible and acceptable to patients, and we found a highly consistent, but statistically non-significant, trend towards higher inpatient engagement and post-discharge use of key portal functions among patients in the intervention group.
在医院测试以患者为中心、基于平板电脑的床边教育干预,并评估该干预措施在增加患者住院期间和出院后使用其患者门户的效果。
我们在一家大型学术医疗中心的医院内科服务中进行了一项随机对照试验。所有参与者在住院期间都提供了 1 天的平板电脑,并根据需要协助门户注册和初始登录。此外,干预组患者接受了重点床边教育,以演示门户的关键功能,并解释这些功能对即将过渡到出院后护理的重要性。我们的主要结果是出院后登录门户并完成特定任务的患者比例。次要结果是观察患者在出院前浏览门户的能力以及报告使用床边平板电脑访问门户的患者满意度。
我们共纳入 97 名参与者(50 名干预组;47 名对照组);总体而言,出院后 7 天内有 57%的患者至少登录过 1 次门户(干预组 58%,对照组 55%)。干预组的平均登录次数更高(3.48 次 vs. 2.94 次对照组),且干预组完成的特定门户任务数量更多;但没有任何单项比较达到统计学意义。干预组在医院登录和浏览门户的能力更高(64% vs. 60%对照组),但只有 1 项特定门户任务具有统计学意义(查看提供方消息标签:92% vs. 77%对照组,P = .04)。实施干预的时间很短(80%的干预时间<15 分钟),干预组对床边平板电脑访问门户的满意度很高(88%满意/非常满意)。
我们的干预措施对患者来说具有高度的可行性和可接受性,并且我们发现干预组患者在住院期间参与度更高,出院后关键门户功能的使用率更高,这一趋势具有高度一致性,但无统计学意义。