Steitz Bryan D, Wong Joseph Isaac S, Cobb Jared G, Carlson Brian, Smith Gaye, Rosenbloom S Trent
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
JAMIA Open. 2019 Sep 17;2(4):479-488. doi: 10.1093/jamiaopen/ooz039. eCollection 2019 Dec.
Patient portal use has increased over the last two decades in response to consumer demand and government regulation. Despite growing adoption, few guidelines exist to direct successful implementation and governance. We describe the policies and procedures that have governed over a decade of continuous My Health at Vanderbilt (MHAV) patient portal use.
We examined MHAV usage data between May 2007 and November 2017. We classified patient portal activity into eight functional categories: Appointment, Billing, Document Access, Genetics, Health Result, Immunization, Medication, and Messaging. We describe our operating policies and measure portal uptake, patient account activity, and function use over time.
By the end of the study period, there were 375 517 registered accounts. Policies made MHAV available to competent adults and adolescents 13 and over. Patients signed up for a limited access account online, which could be upgraded to a full-access account after identity verification. Patients could assign proxy accounts to family and caregivers, which permitted nonpatient access to select MHAV functions. Laboratory and radiology results were accessible via MHAV. Results were classified into three groups based on sensitivity, which govern the length of delay before results appeared in MHAV.
Patient portals offer significant opportunity to engage patients in their healthcare. However, there remains a need to understand how policies can promote uptake and use. We anticipate that other institutions can apply concepts from our policies to support meaningful patient portal engagement.
在过去二十年中,为响应消费者需求和政府监管,患者门户的使用有所增加。尽管采用率不断提高,但指导成功实施和管理的指南却很少。我们描述了在范德比尔特大学(Vanderbilt)连续十多年使用“我的健康”(My Health at Vanderbilt,MHAV)患者门户所遵循的政策和程序。
我们研究了2007年5月至2017年11月期间MHAV的使用数据。我们将患者门户活动分为八个功能类别:预约、计费、文档访问、遗传学、健康结果、免疫接种、药物和消息传递。我们描述了我们的运营政策,并衡量了门户的采用情况、患者账户活动以及随时间推移的功能使用情况。
到研究期结束时,有375517个注册账户。政策规定,13岁及以上的有行为能力的成年人和青少年可以使用MHAV。患者可以在线注册一个有限访问账户,在身份验证后可以升级为完全访问账户。患者可以为家人和护理人员分配代理账户,允许非患者访问某些MHAV功能。实验室和放射学结果可通过MHAV获取。结果根据敏感性分为三组,这决定了结果在MHAV中出现之前的延迟时间。
患者门户为患者参与自身医疗保健提供了重大机会。然而,仍有必要了解政策如何促进采用和使用。我们预计其他机构可以应用我们政策中的概念来支持有意义的患者门户参与。