Patient Perceptions of e-Visits: Qualitative Study of Older Adults to Inform Health System Implementation.
Patient Perceptions of e-Visits: Qualitative Study of Older Adults to Inform Health System Implementation.
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电子就诊（e-visits）是可计费的、异步的患者发起的消息，需要提供者至少五分钟的医疗决策。某些患者群体对电子就诊等患者门户工具的不平等使用可能会加剧健康差距。到目前为止，没有研究试图定性评估的看法，在老年人的电子访问。在这项定性研究中，我们的目的是了解病人的看法，电子访问，包括他们的感知效用，使用障碍，和护理的影响，重点是弱势患者群体。我们进行了一项定性研究，采用深入的结构化个人访谈，从不同背景的患者，以评估他们的知识和看法，周围的电子访问相比，未计费的门户网站的消息和其他访问类型。我们使用内容分析来分析访谈数据。我们进行了20次采访，所有的成年人都超过65岁。我们确定了4个总体编码类别或主题。首先，与会者普遍接受电子访问的概念，并愿意尝试。其次，近三分之二的参与者表示更喜欢同步通信。第三，参与者对“电子就诊”的名称以及何时在患者门户网站中选择这种类型的就诊有具体的关注。第四，一些与会者表示，使用或访问电子访问技术感到不适。使用电子访问的财政障碍不是一个共同的主题。我们的研究结果表明，老年人普遍接受的概念，电子访问，但摄取可能是有限的，由于他们的偏好同步通信。我们确定了改进电子访问实施的几个机会。
Electronic visits (e-visits) are billable, asynchronous patient-initiated messages that require at least five minutes of medical decision-making by a provider. Unequal use of patient portal tools like e-visits by certain patient populations may worsen health disparities. To date, no study has attempted to qualitatively assess perceptions of e-visits in older adults. In this qualitative study, we aimed to understand patient perceptions of e-visits, including their perceived utility, barriers to use, and care implications, with a focus on vulnerable patient groups. We conducted a qualitative study using in-depth structured individual interviews with patients from diverse backgrounds to assess their knowledge and perceptions surrounding e-visits as compared with unbilled portal messages and other visit types. We used content analysis to analyze interview data. We conducted 20 interviews, all in adults older than 65 years. We identified 4 overarching coding categories or themes. First, participants were generally accepting of the concept of e-visits and willing to try them. Second, nearly two-thirds of the participants voiced a preference for synchronous communication. Third, participants had specific concerns about the name “e-visit” and when to choose this type of visit in the patient portal. Fourth, some participants indicated discomfort using or accessing technology for e-visits. Financial barriers to the use of e-visits was not a common theme. Our findings suggest that older adults are generally accepting of the concept of e-visits, but uptake may be limited due to their preference for synchronous communication. We identified several opportunities to improve e-visit implementation.