患者门户、患者生成的图像与儿科门诊环境中的医疗决策。

Patient Portal, Patient-Generated Images, and Medical Decision-Making in a Pediatric Ambulatory Setting.

机构信息

Department of General Surgery, The Jewish Hospital, Cincinnati, Ohio, United States.

Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States.

出版信息

Appl Clin Inform. 2020 Oct;11(5):764-768. doi: 10.1055/s-0040-1718754. Epub 2020 Nov 18.

DOI:10.1055/s-0040-1718754

PMID:33207384

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7673956/

Abstract

BACKGROUND

Electronic health record (EHR) patient portals are a secure electronic method of communicating with health care providers. In addition to sending secure messages, images, and videos generated by families can be sent to providers securely. With the widespread use of smart phones, there has been an increase in patient-generated images (PGI) sent to providers via patient portals. There are few studies that have evaluated the role of PGI in medical decision-making.

OBJECTIVES

The study aimed to characterize PGI sent to providers via a patient portal, determine how often PGI-affected medical decision-making, and determine the rate of social PGI sent via patient portal.

METHODS

A retrospective chart review of PGI uploaded to a children's hospital's ambulatory patient portal from January 2011 to December 2017 was conducted. Data collected included patient demographics, number and type of images sent, person sending images (patient or parent/guardian), and whether an image-affected medical decision-making. Images were classified as medical related (e.g., blood glucose readings and skin rashes), nonmedical or administrative related (e.g., medical clearance or insurance forms), and social (e.g., self-portraits and camp pictures).

RESULTS

One hundred forty-three individuals used the portal a total of 358 times, sending 507 images over the study period. Mean (standard deviation) patient age was 9.5 (5.9) years, 50% were females, 89% were White, and 64% had private insurance. About 9% of images were sent directly by patients and the rest by parents/guardians. A total of 387 (76%) images were sent for medical related reasons, 20% for nonmedical, and 4% were deemed social images. Of the 387 medical related images, 314 (81%) affected medical decision-making.

CONCLUSION

PGI-affected medical decision-making in most cases. Additional studies are needed to characterize use of PGI in the pediatric population.

摘要

背景

电子健康记录 (EHR) 患者门户是一种与医疗保健提供者进行安全通信的电子方式。除了发送安全消息外，还可以安全地将家庭生成的图像、视频发送给提供者。随着智能手机的广泛使用，通过患者门户发送给提供者的患者生成的图像 (PGI) 有所增加。很少有研究评估 PGI 在医疗决策中的作用。

目的

本研究旨在描述通过患者门户发送给提供者的 PGI，确定 PGI 影响医疗决策的频率，以及确定通过患者门户发送的社会 PGI 的比率。

方法

对 2011 年 1 月至 2017 年 12 月期间上传至一家儿童医院门诊患者门户的 PGI 进行回顾性图表审查。收集的数据包括患者人口统计学信息、发送的图像数量和类型、发送图像的人（患者或父母/监护人），以及图像是否影响医疗决策。图像分为与医疗相关（例如，血糖读数和皮疹）、非医疗或行政相关（例如，医疗许可或保险表格）和社会相关（例如，自画像和营地照片）。

结果

共有 143 人总共使用门户 358 次，在研究期间共发送 507 张图像。患者平均年龄（标准差）为 9.5（5.9）岁，50%为女性，89%为白人，64%有私人保险。约 9%的图像由患者直接发送，其余由父母/监护人发送。共有 387 张（76%）图像用于医疗相关原因，20%用于非医疗原因，4%被视为社会图像。在 387 张与医疗相关的图像中，有 314 张（81%）影响了医疗决策。