Patients' continuing use of an online health record: a quantitative evaluation of 14,000 patient years of access data.
Patients' continuing use of an online health record: a quantitative evaluation of 14,000 patient years of access data.
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DOI：
10.2196/jmir.3371
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发表时间：
2014-10-24
影响因子：
7.4
通讯作者：
Turner AN
中科院分区：
文献类型：
--
作者：
Phelps RG;Taylor J;Simpson K;Samuel J;Turner AN
患者广泛要求在线访问其全部或部分健康记录，并且以患者门户的形式提供，至少已被部分患者，特别是患有慢性病的患者大量使用。然而，关于患者长期使用患者可访问的电子健康记录服务的报道很少，这对于分配资源很重要。 Renal PatientView (RPV) 是一个成熟的系统，让慢性肾病患者能够获取实时检测结果以及有关其病情和治疗的信息。英国大多数肾病单位都可以使用该药物，在某些中心注册的特定患者群体中高达 75%。我们分析了患者 4 年的使用情况，并调查了与更持久使用相关的因素。我们的目的是调查患者从初次注册起随时间推移的 RPV 使用情况，以了解哪些患者选择使用 RPV 以及其对不同患者群体的吸引力的持久性。我们分析了 RPV 基础数据库的匿名摘录，其中包含患者注册和事件的信息，包括患者访问以及新血液检测结果或患者可能希望查看的信件的到达。在提取数据时，有 11,352 名患者在 RPV 上登记了 0-42 个月（中位数 17）。超过一半的注册者成为持久用户，在注册后长达 42 个月的时间间隔内每月平均登录 2.0 次（中位数 18.9 次）。首次登录时提供的帮助与成为持久用户密切相关，即使是三年后也是如此。持续用户的登录发生在咨询/测试期间，强烈表明患者的参与度。虽然表明贫困程度更大的指数是不参与的最强决定因素，但它们对已建立用户的退出率的影响可以忽略不计。在这个成熟的患者门户系统中，很大一部分患者长期定期使用他们的在线健康记录。使用模式和时间表明患者对详细信息（例如最近的测试结果和临床信件）有强烈的兴趣。通过建立对患者在线记录的访问的第一步来支持患者，与 RPV 的长期使用率大大提高有关，并且可能会增加为慢性病患者提供的其他电子健康记录的使用。
Online access to all or part of their health records is widely demanded by patients and, where provided in form of patient portals, has been substantially used by at least subgroups of patients, particularly those with chronic disease. However, little is reported regarding the longer-term patient use of patient-accessible electronic health record services, which is important in allocating resources. Renal PatientView (RPV) is an established system that gives patients with chronic kidney disease access to live test results and information about their condition and treatment. It is available in most UK renal units with up to 75% of particular patient groups registered in some centers. We have analyzed patient use out to 4 years and investigated factors associated with more persistent use. Our aim was to investigate RPV use by patients over time from initial registration in order to understand which patients choose to access RPV and the endurance of its appeal for different patient groups. We analyzed an anonymized extract of the database underlying RPV containing information on patient registration and events including patient access and the arrival of new blood test results or letters that patients might wish to view. At the time of the extract, there were 11,352 patients registered on RPV for 0-42 months (median 17). More than half of registrants became persistent users, logging in a median of 2.0 times each month over post-registration intervals of up to 42 months (median 18.9). Provision of assistance with first logon was strongly associated with becoming a persistent user, even at 3 years. Logons by persistent users occurred around the time of consultations/tests, strongly suggestive of patient engagement. While indices indicative of greater deprivation were the strongest determinants of non-participation, they had negligible influence on drop-out rates among established users. In this mature patient portal system, a large proportion of patients made regular use of their online health records over protracted periods. The patterns and timing of use indicate strong patient interest in detailed information such as recent test results and clinic letters. Supporting patients through the first steps of establishing access to their online records is associated with much higher rates of long-term use of RPV and likely would increase use of other electronic health records provided for patients with chronic disease.
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影响因子：
1
作者：
Burke, Redmond P.;Rossi, Anthony F.;White, Jeffrey A.
通讯作者：
White, Jeffrey A.
影响因子：
3
作者：
Lustria, Mia Liza A.;Smith, Scott Alan;Hinnant, Charles C.
通讯作者：
Hinnant, Charles C.
影响因子：
3.5
作者：
Bartlett, Cherry;Simpson, Keith;Turner, A. Neil
通讯作者：
Turner, A. Neil
影响因子：
5.7
作者：
Ancker, Jessica S.;Barron, Yolanda;Calman, Neil
通讯作者：
Calman, Neil
DOI：
10.1197/jamia.m1672
发表时间：
2005-03-01
影响因子：
6.4
作者：
Hsu, J;Huang, J;Ortiz, E
通讯作者：
Ortiz, E