基于患者门户的预先医疗指示工具的设计与实现。
Design and Implementation of Patient Portal-Based Advance Care Planning Tools.
机构信息
Rocky Mountain Regional VA Geriatric Research Education and Clinical Center, Denver, Colorado, USA; Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
出版信息
J Pain Symptom Manage. 2019 Jan;57(1):112-117.e2. doi: 10.1016/j.jpainsymman.2018.10.500. Epub 2018 Oct 25.
BACKGROUND
Electronic health record-based portal tools may help patients engage in advance care planning (ACP). We designed and implemented portal-based ACP tools to enable patients to create a medical durable power of attorney (MDPOA).
MEASURES
MDPOA documentation and System Usability Scale were assessed.
INTERVENTION
Stakeholder-informed portal-based ACP tools include an electronic MDPOA form, patient educational webpage, online messaging, and patient access to completed advance directives.
OUTCOMES
A total of 2814 patients used the tools over 15 months. Patients had a mean age 45 years (17-98 years) and 69% were women. Eighty-nine percent completed an MDPOA form, 2% called or sent online messages, and 8% viewed the MDPOA form but did not complete it. The tools were rated highly usable.
CONCLUSIONS/LESSONS LEARNED: Patients demonstrated willingness to use the portal to complete an MDPOA and rated the new ACP tools as highly usable. Future work will optimize population-based outreach strategies to engage patients in ACP through the portal.
背景
基于电子健康记录的门户工具可能有助于患者参与预先护理计划（ACP）。我们设计并实施了基于门户的 ACP 工具，使患者能够创建医疗持久授权书（MDPOA）。
措施
评估了 MDPOA 文档和系统可用性量表。
干预措施
利益相关者知情的基于门户的 ACP 工具包括电子 MDPOA 表格、患者教育网页、在线消息传递以及患者访问已完成的预先指示。
结果
在 15 个月的时间里，共有 2814 名患者使用了这些工具。患者的平均年龄为 45 岁（17-98 岁），其中 69%为女性。89%的患者完成了 MDPOA 表格，2%的患者打电话或发送在线消息，8%的患者查看了 MDPOA 表格但未完成。这些工具的可用性评价很高。
结论/经验教训：患者表现出愿意使用门户来完成 MDPOA，并对新的 ACP 工具评价很高。未来的工作将优化基于人群的外展策略，通过门户让患者参与 ACP。
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