Department of Information Systems, University of Maryland, Baltimore County, Baltimore, Maryland, United States.
Vanderbilt University Medical Center, Nashville, Tennessee, United States.
Appl Clin Inform. 2023 Aug;14(4):654-669. doi: 10.1055/s-0043-1770901. Epub 2023 Aug 23.
Recent external factors-the 21st Century Cures Act and the coronavirus disease 2019 (COVID-19) pandemic-have stimulated major changes in the patient portal landscape. The objective of this state-of-the-art review is to describe recent developments in the patient portal literature and to identify recommendations and future directions for the design, implementation, and evaluation of portals.
To focus this review on salient contemporary issues, we elected to center it on four topics: (1) 21st Century Cures Act's impact on patient portals (e.g., Open Notes); (2) COVID-19's pandemic impact on portals; (3) proxy access to portals; and (4) disparities in portal adoption and use. We conducted targeted PubMed searches to identify recent empirical studies addressing these topics, used a two-part screening process to determine relevance, and conducted thematic analyses.
Our search identified 174 unique papers, 74 were relevant empirical studies and included in this review. Among these papers, we identified 10 themes within our four a priori topics, including preparing for and understanding the consequences of increased patient access to their electronic health information (Cures Act); developing, deploying, and evaluating new virtual care processes (COVID-19); understanding current barriers to formal proxy use (proxy access); and addressing disparities in portal adoption and use (disparities).
Our results suggest that the recent trends toward understanding the implications of immediate access to most test results, exploring ways to close gaps in portal adoption and use among different sub-populations, and finding ways to leverage portals to improve health and health care are the next steps in the maturation of patient portals and are key areas that require more research. It is important that health care organizations share their innovative portal efforts, so that successful measures can be tested in other contexts, and progress can continue.
最近的外部因素——《21 世纪治愈法案》和 2019 年冠状病毒病（COVID-19）大流行——刺激了患者门户领域的重大变化。本综述的目的是描述患者门户文献的最新进展，并为门户的设计、实施和评估确定建议和未来方向。
为了将本综述集中在突出的当代问题上，我们选择围绕四个主题：（1）《21 世纪治愈法案》对患者门户的影响（例如，开放注释）；（2）COVID-19 大流行对门户的影响；（3）代理访问门户；（4）门户采用和使用方面的差异。我们进行了有针对性的 PubMed 搜索，以确定解决这些主题的最近的实证研究，使用两步筛选过程来确定相关性，并进行主题分析。
我们的搜索确定了 174 篇独特的论文，其中 74 篇是相关的实证研究，并包含在本综述中。在这些论文中，我们在四个预先确定的主题中确定了 10 个主题，包括为增加患者对其电子健康信息的访问做好准备并了解其后果（治愈法案）；开发、部署和评估新的虚拟护理流程（COVID-19）；了解正式代理使用的当前障碍（代理访问）；以及解决门户采用和使用方面的差异（差异）。
我们的研究结果表明，最近的趋势是理解立即访问大多数测试结果的影响，探索缩小不同亚人群中门户采用和使用差距的方法，以及寻找利用门户改善健康和医疗保健的方法，是患者门户成熟的下一步，也是需要更多研究的关键领域。医疗保健组织共享其创新的门户工作非常重要，以便在其他环境中测试成功的措施，并继续取得进展。
