Kaiser Permanente Division of Research, Oakland, CA.
University of Tennessee Health Science Center, Memphis, TN.
Med Care. 2019 Oct;57(10):809-814. doi: 10.1097/MLR.0000000000001178.
Personal health records offer patients access to view their own health information and to manage their care online through secure patient portal tools. Little is known about the patient-reported experience in using health portals to manage chronic conditions.
In a patient-centered research study, we examined how using portal tools affects patient health care experiences among patients with chronic conditions. We also examined barriers among nonportal users.
A cross-sectional patient survey.
Patients with a chronic condition in an integrated delivery system offering a patient portal.
Respondents reported barriers, preferences, and experiences in using the patient portal, and whether using the portal changed their overall health.
Among all the 1824 respondents (70% response rate), portal nonusers reported preferring in-person health care (54%) or experiencing internet access barriers (41%). Portal users reported that using the portal was convenient (90%), the information available was useful (92%), and that it integrated well with other health care (92%). Among users, 31% reported that using the portal had improved their overall health. After adjustment, patients were significantly more likely to report that portal use improved their health if they had also reported convenience, information usefulness, or integration with other care (P<0.05). Reassuringly, patient-reported impacts on overall health did not vary by patient characteristics (including age, race, sex, education, income, complex conditions).
Patients with chronic conditions using the portal reported convenience, information usefulness, and integration of the patient portal with their health care; these may act as potential pathways improving health.
个人健康记录为患者提供了在线查看自己健康信息和管理护理的途径，通过安全的患者门户工具。但对于患者使用健康门户来管理慢性病的体验，我们知之甚少。
在一项以患者为中心的研究中，我们研究了使用门户工具如何影响慢性病患者的医疗体验。我们还研究了非门户用户的障碍。
一项横断面患者调查。
在提供患者门户的综合交付系统中患有慢性病的患者。
受访者报告了使用患者门户的障碍、偏好和体验，以及使用门户是否改变了他们的整体健康状况。
在所有 1824 名受访者（70%的回应率）中，非门户用户报告更喜欢面对面的医疗保健（54%）或遇到互联网接入障碍（41%）。门户用户报告使用门户方便（90%），可用信息有用（92%），与其他医疗保健整合良好（92%）。在用户中，31%的人报告使用门户改善了他们的整体健康状况。调整后，如果患者报告便利性、信息有用性或与其他护理的整合性提高，他们更有可能报告使用门户改善了他们的健康状况（P<0.05）。令人欣慰的是，患者报告的整体健康影响不因患者特征（包括年龄、种族、性别、教育、收入、复杂状况）而异。
使用门户的慢性病患者报告了便利性、信息有用性以及患者门户与他们的医疗保健的整合；这些可能是改善健康的潜在途径。
