A Web-Based Patient Portal for Mental Health Care: Benefits Evaluation
A Web-Based Patient Portal for Mental Health Care: Benefits Evaluation
复制标题
DOI：
10.2196/jmir.6483
复制
发表时间：
2016-11-01
影响因子：
7.4
通讯作者：
Riahi, Sanaz
中科院分区：
文献类型：
--
作者：
Kipping, Sarah;Stuckey, Melanie I.;Riahi, Sanaz
背景：精神疾病的治疗已经从单纯关注症状治疗转向关注个人康复。患者激活是恢复过程的重要组成部分。患者门户网站已显示出增加初级和急性护理环境中激活的前景，但对三级精神卫生保健的益处仍然未知。目的：对接受严重或持续性精神疾病治疗的患者进行基于Web的门户网站的获益评估，以检查对（1）患者激活，（2）恢复，（3）生产力，和（4）行政效率。方法：所有登记的住院病人和门诊病人在三级精神卫生保健设施提供了机会，登记和利用病人门户网站。选择使用门户网站的人和不选择使用门户网站的人分别被指定为“用户”和“非用户”。所有患者均接受常规治疗。用户可以通过Web访问查看部分电子医疗记录，查看即将到来的预约，并与他们的医疗保健提供者进行沟通。用户可以参加由参与协调员或同行支持专家主持的门户培训或支持会议。创建并使用门户网站账户的患者子集在基线（入组后即刻; n=91）和随访（6个月和10个月; n=65）时完成了2项基于网络的调查。心理健康恢复指标（MHRM）的总分是患者激活的代表，并且各个领域测量恢复情况。系统和使用情况调查工具（SUS）审查了门户网站功能的使用情况和一般反馈意见。通过检查门户用户和非用户错过预约的几率来评估组织效率（生产力）或从健康信息管理部门请求信息（行政效率）在门户实施前一年（2014年）和实施后一年（2015年）的情况。共有461例患者（44.0%男性，n=203）注册了该门户网站，在1年随访期内使用了4761次。大多数使用（95.34%，4539/4761）是电子视图。总体MHRM评分从基线时的70.4（SD 23.6）增加至合并随访时的81.7（SD 25.1）（P=.01）。在8个恢复域中，7个在随访时增加（均P
Background: Treatment for mental illness has shifted from focusing purely on treatment of symptoms to focusing on personal recovery. Patient activation is an important component of the recovery journey. Patient portals have shown promise to increase activation in primary and acute care settings, but the benefits to tertiary level mental health care remain unknown.Objective: To conduct a benefits evaluation of a Web-based portal for patients undergoing treatment for serious or persistent mental illness in order to examine the effects on (1) patient activation, (2) recovery, (3) productivity, and (4) administrative efficiencies.Methods: All registered inpatients and outpatients at a tertiary level mental health care facility were offered the opportunity to enroll and utilize the patient portal. Those who chose to use the portal and those who did not were designated as "users" and "nonusers," respectively. All patients received usual treatment. Users had Web-based access to view parts of their electronic medical record, view upcoming appointments, and communicate with their health care provider. Users could attend portal training or support sessions led by either the engagement coordinator or peer support specialists. A subset of patients who created and utilized their portal account completed 2 Web-based surveys at baseline (just after enrollment; n=91) and at follow-up (6 and 10 months; n=65). The total score of the Mental Health Recovery Measure (MHRM) was a proxy for patient activation and the individual domains measured recovery. The System and Use Survey Tool (SUS) examined the use of functions and general feedback about the portal. Organizational efficiencies were evaluated by examining the odds of portal users and nonusers missing appointments (productivity) or requesting information from health information management (administrative efficiencies) in the year before (2014) and the year after (2015) portal implementation.Results: A total of 461 patients (44.0% male, n=203) registered for the portal, which was used 4761 times over the 1-year follow-up period. The majority of uses (95.34%, 4539/4761) were for e-views. The overall MHRM score increased from 70.4 (SD 23.6) at baseline to 81.7 (SD 25.1) at combined follow-up (P=.01). Of the 8 recovery domains, 7 were increased at follow-up (all P