Patient and Provider Attitudes Toward the Use of Patient Portals for the Management of Chronic Disease: A Systematic Review
Patient and Provider Attitudes Toward the Use of Patient Portals for the Management of Chronic Disease: A Systematic Review
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患者和医疗服务提供者对使用患者门户管理慢性病的态度：系统评价
DOI：
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发表时间：
2015
影响因子：
7.4
通讯作者：
A. Nair
中科院分区：
文献类型：
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作者：
C. Kruse;Darcy A Argueta;L. Lopez;A. Nair
患者门户网站为患者提供了更好地管理和了解其健康状况的工具。然而，由于多种原因，患者门户网站的广泛采用面临着来自患者和提供者的阻力，并且评估患者门户网站的特征的证据有限，这些患者门户网站收到了患者和提供者的积极评价。目的本系统评价的目的是确定从患者和提供者获得良好反应的门户网站的共同特征，并确定患者和提供者认为需要改进的要素。方法：作者对CINAHL和PubMed数据库进行了系统检索，以收集有关慢性病管理中患者门户网站使用的数据。两名评审员分析了检索过程中收集的文献，以删除不相关的文献。作者选择了27篇文章用于文献综述。结果本系统评价的结果得出结论，患者门户网站显示了显着改善患者的慢性病自我管理，提高了提供者提供的护理质量。最普遍的积极属性是患者-提供者沟通，这出现在27篇文章中的10篇（37%）。患者和供应商都注意到了这一点。最普遍的负面看法是安全性（担忧）和用户友好性，这两个方面都出现在27篇文章中的11篇（41%）。对于不熟悉先进技术的患者和提供者来说，用户友好性质量是一个问题，因此很难浏览患者门户网站。毫不奇怪，门户系统的安装和维护成本高昂，阻碍了一些提供商将此类技术应用于实践，但这仅在27篇文章中的3篇（11%）中提到。有意义使用的激励措施可能会缓解成本障碍。结论：本系统性综述揭示了患者及其提供者对使用患者门户网站管理其慢性疾病的不同态度。作者认为，标准的患者门户网站设计为患者提供了解和管理其慢性疾病的资源，将促进医疗保健组织采用患者门户网站。
Background Patient portals provide patients with the tools to better manage and understand their health status. However, widespread adoption of patient portals faces resistance from patients and providers for a number of reasons, and there is limited evidence evaluating the characteristics of patient portals that received positive remarks from patients and providers. Objective The objectives of this systematic review are to identify the shared characteristics of portals that receive favorable responses from patients and providers and to identify the elements that patients and providers believe need improvement. Methods The authors conducted a systematic search of the CINAHL and PubMed databases to gather data about the use of patient portals in the management of chronic disease. Two reviewers analyzed the articles collected in the search process in order remove irrelevant articles. The authors selected 27 articles to use in the literature review. Results Results of this systematic review conclude that patient portals show significant improvements in patient self-management of chronic disease and improve the quality of care provided by providers. The most prevalent positive attribute was patient-provider communication, which appeared in 10 of 27 articles (37%). This was noted by both patients and providers. The most prevalent negative perceptions are security (concerns) and user-friendliness, both of which occurred in 11 of 27 articles (41%). The user-friendliness quality was a concern for patients and providers who are not familiar with advanced technology and therefore find it difficult to navigate the patient portal. The high cost of installation and maintenance of a portal system, not surprisingly, deters some providers from implementing such technology into their practice, but this was only mentioned in 3 of the 27 articles (11%). It is possible that the incentives for meaningful use assuage the barrier of cost. Conclusions This systematic review revealed mixed attitudes from patients and their providers regarding the use of patient portals to manage their chronic disease. The authors suggest that a standard patient portal design providing patients with the resources to understand and manage their chronic conditions will promote the adoption of patient portals in health care organizations.