Use and the Users of a Patient Portal: Cross-Sectional Study.
Use and the Users of a Patient Portal: Cross-Sectional Study.
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DOI：
10.2196/jmir.9418
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发表时间：
2018-09-17
影响因子：
7.4
通讯作者：
van Os-Medendorp H
中科院分区：
文献类型：
--
作者：
Hoogenbosch B;Postma J;de Man-van Ginkel JM;Tiemessen NA;van Delden JJ;van Os-Medendorp H
患者门户为患者提供访问他们的医疗信息和与医疗保健提供者交流的工具。已经表明，患者门户有可能对健康结果和卫生保健效率产生积极影响。因此，卫生保健组织必须确定使用或不使用患者门户的患者，并探索这两种情况的原因。技术接受和使用的统一理论(UTAUT)是解释信息技术使用的常用理论。它由以下结构组成：绩效期望、努力期望、社会影响力、促进条件和使用行为意图。本研究旨在探讨患者门户网站的使用情况以及使用或不使用患者门户网站的患者的特征。UTAUT的主要结构，以及人口统计学、疾病和护理相关特征，已经被测量，以探索门户使用的预测因素。荷兰一所大学医院的成人门诊部进行了一项横断面研究。研究结果包括：自我报告的门户网站使用情况、用户特征，如人口统计数据、疾病和护理相关数据、电子健康素养(修改后的分数)和UTAUT结构得分。采用描述性分析、单因素和多因素Logistic回归分析。在分析中，纳入了439名成年患者。此外，32.1%(141/439)的人被确认为患者门户的用户；31.2%(137/439)的人表示不使用该门户，但知道该门户的存在；36.6%(161/439)的非用户不知道该门户的存在。在整个研究人群中，慢性病(OR 1.62，95%CI 1.04-2.52)和电子健康素养(修正分数；OR 1.12，95%CI 1.07-1.18)是门户使用的最好预测因素。在知道门户的用户和非用户中，UTAUT结构被添加到多变量Logistic回归中，并带有慢性病和修改后的电子健康素养总分。工作期望(OR 13.02，95%可信区间5.68-29.87)和绩效预期(OR 2.84，95%可信区间1.65-4.90)对门户网站的使用有显著影响。在一所大学医院，大约三分之一的患者自我报告使用了患者门户；大多数人表示满意。乍一看，患有慢性病和在修改后的电子健康扫盲量表上得分较高可以解释门户的使用。将UTAUT结构添加到模型中表明，工作预期(易用性以及与门户使用相关的知识和技能)和性能预期(感知的有用性)影响门户使用。需要采取干预措施，提高患者对门户网站和电子健康素养技能的认识，并将患者门户网站进一步整合到日常面对面护理中，以增加使用量和潜在的后续患者利益。
Patient portals offer patients access to their medical information and tools to communicate with health care providers. It has been shown that patient portals have the potential to positively impact health outcomes and efficiency of health care. It is therefore important that health care organizations identify the patients who use or do not use the patient portal and explore the reasons in either case. The Unified Theory of Acceptance and Use of Technology (UTAUT) is a frequently used theory for explaining the use of information technology. It consists of the following constructs: performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention to use. This study aimed to explore the prevalence of patient portal use and the characteristics of patients who use or do not use a patient portal. The main constructs of UTAUT, together with demographics and disease- and care-related characteristics, have been measured to explore the predictive factors of portal use. A cross-sectional study was conducted in the outpatient departments for adult patients of a university hospital in the Netherlands. Following outcomes were included: self-reported portal use, characteristics of users such as demographics, disease- and care-related data, eHealth literacy (modified score), and scores of UTAUT constructs. Descriptive analyses and univariate and multivariate logistic regression were also conducted. In the analysis, 439 adult patients were included. Furthermore, 32.1% (141/439) identified as being a user of the patient portal; 31.2% (137/439) indicated as nonusers, but being aware of the existence of the portal; and 36.6% (161/439) as being nonusers not aware of the existence of the portal. In the entire study population, the factors of being chronically ill (odds ratio, OR 1.62, 95% CI 1.04-2.52) and eHealth literacy (modified score; OR 1.12, 95% CI 1.07-1.18) best predicted portal use. In users and nonusers who were aware of the portal, UTAUT constructs were added to the multivariate logistic regression, with chronically ill and modified eHealth literacy sum score. Effort expectancy (OR 13.02, 95% CI 5.68-29.87) and performance expectancy (OR 2.84, 95% CI 1.65-4.90) are shown to significantly influence portal use in this group. Approximately one-third of the patients of a university hospital self-reported using the patient portal; most expressed satisfaction. At first sight, being chronically ill and higher scores on the modified eHealth literacy scale explained portal use. Adding UTAUT constructs to the model revealed that effort expectancy (ease of use and knowledge and skills related to portal use) and performance expectancy (perceived usefulness) influenced portal use. Interventions to improve awareness of the portal and eHealth literacy skills of patients and further integration of the patient portal in usual face-to-face care are needed to increase use and potential subsequent patient benefits.
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影响因子：
7.4
作者：
Agarwal R;Anderson C;Zarate J;Ward C
通讯作者：
Ward C
影响因子：
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作者：
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通讯作者：
Hosmer, David W
影响因子：
7.4
作者：
Haun, Jolie N;Patel, Nitin R;Antinori, Nicole
通讯作者：
Antinori, Nicole
影响因子：
4.4
作者：
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通讯作者：
Cohn, Jeffrey
影响因子：
4.5
作者：
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