DesRoches Catherine M, Wachenheim Deborah, Ameling Jessica, Cibildak Aysel, Cibotti Nancy, Dong Zhiyong, Drane Alexandra, Hurwitz Isabel, Meddings Jennifer, Naimark Jody, O'Donnell Kimberly, Winger Christine, Winnay Sarah Stephens, Young Jordan, Wolff Jennifer L
OpenNotes, Department of Medicine, Harvard Medical School, Boston, MA, United States.
OpenNotes, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.
JMIR Res Protoc. 2025 Mar 4;14:e66708. doi: 10.2196/66708.
In the United States, the landscape of unpaid care delivery is both challenging and complex, with millions of individuals undertaking the vital role of helping families (broadly defined) manage their health care and well-being. This includes 48 million caregivers of adults, 42 million of whom are caregivers of adults aged 50 years or older. These family care partners provide critical and often daily support for tasks such as dressing and bathing, as well as managing medications, medical equipment, appointments, and follow-up care plans.
This study aimed to implement a novel patient portal-based intervention to identify, engage, and support care partners in clinical settings.
The project team collaborated with 3 health care organizations (6 primary care practices in total) to design and implement a patient portal-based intervention. Three days in advance of a visit, patients were invited to log on to their patient portal account and answer a brief questionnaire as part of the routine electronic check-in process asking them to (1) identify themselves as the patient or someone answering for the patient, (2) report major life changes, (3) set the agenda for the upcoming visit, and (4) report on care partner responsibilities. Respondents' answers to this brief questionnaire were available to providers ahead of the visit. Patients with care partner responsibilities, as well as care partners answering the questionnaire on behalf of patients, were provided a link to the ARCHANGELS Caregiver Intensity Index to measure the intensity of their caregiving role and motivate care partners to connect with suggested state and local resources.
The intervention was launched in September 2022 at Organization A. Organization B launched in May 2023 in one clinic and June 2023 in the other. In focus groups, staff and clinicians reported that the intervention was easy to implement and did not cause workflow disruption. At 6 months post implementation, across both organizations, a total of 22,152 patients had received questionnaires and 13,825 (62.4%) had submitted completed questionnaires. Full data will be reported at the completion of the intervention period.
Early results suggest that the intervention could be an easily scalable and adaptable method of identifying and supporting care partners in clinical settings.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66708.
在美国，无偿护理服务的情况既具有挑战性又复杂，数百万个人承担着帮助家庭（广义定义）管理其医疗保健和福祉的重要角色。这包括4800万成年护理人员，其中4200万是50岁及以上成年人的护理人员。这些家庭护理伙伴为诸如穿衣和洗澡等任务提供关键且通常是日常的支持，以及管理药物、医疗设备、预约和后续护理计划。
本研究旨在实施一种基于新型患者门户的干预措施，以在临床环境中识别、吸引并支持护理伙伴。
项目团队与3个医疗保健组织（总共6个初级保健机构）合作，设计并实施基于患者门户的干预措施。在就诊前三天，患者被邀请登录其患者门户账户，并回答一份简短问卷，作为常规电子报到流程的一部分，要求他们（1）表明自己是患者本人还是替患者回答问题的人，（2）报告重大生活变化，（3）设定即将到来的就诊议程，以及（4）报告护理伙伴的职责。提供者在就诊前可以看到受访者对这份简短问卷的回答。有护理伙伴职责的患者以及代表患者回答问卷的护理伙伴，会收到一个链接，可访问天使护理者强度指数，以衡量其护理角色的强度，并促使护理伙伴与建议的州和地方资源建立联系。
该干预措施于2022年9月在A组织启动。B组织于2023年5月在一个诊所启动，6月在另一个诊所启动。在焦点小组中，工作人员和临床医生报告称该干预措施易于实施，且未造成工作流程中断。在实施后6个月，两个组织中共有22152名患者收到问卷，其中13825名（62.4%）提交了完整问卷。完整数据将在干预期结束时报告。
早期结果表明，该干预措施可能是一种易于扩展和适应的方法，可在临床环境中识别和支持护理伙伴。
国际注册报告识别号（IRRID）：DERR1-10.2196/66708。
