Patient Portals and Patient Engagement: A State of the Science Review.
Patient Portals and Patient Engagement: A State of the Science Review.
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DOI：
10.2196/jmir.4255
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发表时间：
2015-06-23
影响因子：
7.4
通讯作者：
Curran CR
中科院分区：
文献类型：
--
作者：
Irizarry T;DeVito Dabbs A;Curran CR
患者门户(即，与机构电子健康记录捆绑在一起的电子个人健康记录)被认为是支持更多患者参与的一种有前途的机制，但仍然存在一些问题，即医疗保健领导人、政策制定者和设计者如何鼓励患者门户的采用，以及哪些因素可能有助于持续利用。这篇科学综述的目的是(1)介绍患者门户的定义、背景和当前文献如何通过患者门户鼓励和支持患者参与，以及(2)总结患者门户研究和发展的未来方向，以有意义地影响患者参与。我们检索了PubMed、Ovid Medline和QicINFO从2006年到2014年的文献，检索词为“患者门户”、“个人健康记录”或“电子个人健康记录”。最终纳入标准规定，研究报告患者的体验和/或支持患者做出有能力的医疗决策并使用患者门户功能对这些决策采取行动的方式。我们发现了120项符合纳入标准的研究。根据研究问题、研究的明确和隐含目标以及相关措施，研究被分为五个主要主题(患者采用、提供者认可、健康素养、可用性和实用性)。我们讨论了针对这五个主题领域的研究的结果和结论。目前的研究表明，患者使用患者门户网站的兴趣和能力受到个人因素的强烈影响，如年龄、种族、教育水平、健康素养、健康状况和作为照顾者的角色。医疗保健交付因素，主要是提供者认可和患者门户可用性，也有助于患者通过患者门户参与并与患者门户互动。未来的研究方向应该集中于确定特定的人群和背景考虑因素，这些因素将从通过患者门户更大程度的患者参与中受益最大。最终，当现有的患者门户功能与患者和提供商的信息需求和功能保持一致时，患者就会采用并得到提供商的认可。
Patient portals (ie, electronic personal health records tethered to institutional electronic health records) are recognized as a promising mechanism to support greater patient engagement, yet questions remain about how health care leaders, policy makers, and designers can encourage adoption of patient portals and what factors might contribute to sustained utilization. The purposes of this state of the science review are to (1) present the definition, background, and how current literature addresses the encouragement and support of patient engagement through the patient portal, and (2) provide a summary of future directions for patient portal research and development to meaningfully impact patient engagement. We reviewed literature from 2006 through 2014 in PubMed, Ovid Medline, and PsycInfo using the search terms “patient portal” OR “personal health record” OR “electronic personal health record”. Final inclusion criterion dictated that studies report on the patient experience and/or ways that patients may be supported to make competent health care decisions and act on those decisions using patient portal functionality. We found 120 studies that met the inclusion criteria. Based on the research questions, explicit and implicit aims of the studies, and related measures addressed, the studies were grouped into five major topics (patient adoption, provider endorsement, health literacy, usability, and utility). We discuss the findings and conclusions of studies that address the five topical areas. Current research has demonstrated that patients’ interest and ability to use patient portals is strongly influenced by personal factors such age, ethnicity, education level, health literacy, health status, and role as a caregiver. Health care delivery factors, mainly provider endorsement and patient portal usability also contribute to patient’s ability to engage through and with the patient portal. Future directions of research should focus on identifying specific populations and contextual considerations that would benefit most from a greater degree of patient engagement through a patient portal. Ultimately, adoption by patients and endorsement by providers will come when existing patient portal features align with patients’ and providers’ information needs and functionality.