Khalil Nadia, Aungst Angela, Casady Lise, Allison Kevin, Fiascki Ryann, Curbelo Christian, Maldonado Janice, Robertson Derrick
Department of Neurology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA (NK, AA, LC, KA, RF, CC, JM, DR).
Int J MS Care. 2022 Nov-Dec;24(6):271-274. doi: 10.7224/1537-2073.2020-101. Epub 2022 Aug 3.
Understanding patterns of MyChart (Epic Systems Corporation) messaging has the potential to alter clinical practice. However, because most research evaluating its use has been conducted in limited contexts, utilization patterns in patients with multiple sclerosis (MS) remain unclear. We characterized factors associated with high rates of MyChart messaging for patients with MS at an academic outpatient clinic.
We performed a retrospective cross-sectional analysis of 439 patients in our center's database. Inclusion criteria were 1 or more clinic visits and MS diagnosis. We extracted demographic data, disease-specific characteristics, and MyChart messaging information.
Of the patients in the database, 324 (74%) were MyChart users. MyChart users were more often younger (mean ± SD age, 50.1 ± 12.6 vs 55.0 ± 13.7 years; < .001), had shorter mean ± SD duration since diagnosis (11.9 ± 8.3 vs 15.8 ± 10.8 years; = .0013), had lower mean ± SD Patient-Determined Disease Steps scale scores (2.8 ± 2.3 vs 3.5 ± 2.5; = .0107), and were more likely to be using high-efficacy disease-modifying therapies (χ = 6.7; = .009). Messaging rates correlated positively with total number of unique medications ( = 0.17; = .003) and negatively with age ( = -0.11; = .018).
Although previous research has implicated arm-hand disability and impaired vision as barriers to patient portal use, these findings suggest the relationship between MS-specific disease burden and MyChart utilization is also a function of underlying medical complexity beyond physical disability. These data may serve as groundwork for investigations in other disease-specific settings and for quality improvement research to mitigate these high rates in at-risk patients to optimize provider time investment, clinic productivity, and patient safety and minimize health care provider burnout.
了解MyChart（Epic系统公司）的信息传递模式有可能改变临床实践。然而，由于大多数评估其使用情况的研究都是在有限的背景下进行的，多发性硬化症（MS）患者的使用模式仍不清楚。我们对一家学术门诊诊所中MS患者MyChart信息传递率高的相关因素进行了特征分析。
我们对中心数据库中的439名患者进行了回顾性横断面分析。纳入标准为1次或更多次门诊就诊及MS诊断。我们提取了人口统计学数据、疾病特异性特征和MyChart信息传递信息。
数据库中的患者有324名（74%）是MyChart用户。MyChart用户更年轻（平均±标准差年龄，50.1±12.6岁对55.0±13.7岁；P<.001），自诊断以来的平均±标准差病程更短（11.9±8.3年对15.8±10.8年；P = 0.0013），患者确定的疾病阶段量表平均±标准差得分更低（2.8±2.3对3.5±2.5；P = 0.0107），并且更有可能正在使用高效疾病修饰疗法（χ² = 6.7；P = 0.009）。信息传递率与独特药物总数呈正相关（r = 0.17；P = 0.003），与年龄呈负相关（r = -0.11；P = 0.018）。
尽管先前的研究表明手臂手部残疾和视力受损是患者使用门户网站的障碍，但这些发现表明，MS特异性疾病负担与MyChart使用之间的关系也是潜在医疗复杂性的一个函数，而不仅仅是身体残疾。这些数据可为其他疾病特异性环境中的研究以及质量改进研究奠定基础，以降低高危患者的这些高信息传递率，优化医疗服务提供者的时间投入、诊所工作效率以及患者安全，并尽量减少医疗服务提供者的倦怠。
