Engaging Diverse Patients in Using an Online Patient Portal

让不同的患者参与使用在线患者门户

• 批准号: 8598816
• 负责人: COURTNEY REES LYLES
• 金额: $ 15.44万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8598816
• 关键词: Engaging; Diverse; Patients; Using; Online

DESCRIPTION (provided by applicant): This is an application for a K99/R00 award for Dr. Courtney Lyles, PhD, a health services researcher at the University of California San Francisco, who is establishing herself as a young investigator examining health information technology use among diverse diabetes patients. This award will provide her with the support to transition to an independent academic researcher and to accomplish the following goals: 1) to become an expert in using comparative effectiveness research methods to understand the influence of online patient portal use on diabetes outcomes within racial/ethnic minority groups, 2) to employ qualitative and implementation science skills to understand barriers to portal use and to design a new approach to patient engagement, 3) to apply these rigorous approaches within an integrated delivery system with a mature electronic system (Kaiser Permanente Northern California) and a safety net public hospital system currently implementing an online patient portal (San Francisco General Hospital, SFGH). Dr. Lyles has assembled a multi-disciplinary mentoring team, led by Dr. Dean Schillinger, MD, who is an expert in designing and rigorously evaluating innovative interventions in this safety net setting. This team also includes: Dr. Andrew Karter, PhD, a senior investigator at Kaiser with expertise in racial/ethnic healthcare disparities and comparative effectiveness methodologies; Dr. Rena Pasick, DrPH, a professor at UCSF who is a national leader in mixed methods approaches to understanding diverse patient preferences and needs; Dr. James Ralston, MD, MPH, an investigator at Group Health Research Institute who is an expert in patient portals and designing interventions utilizing technology to improve diabetes care; and Dr. Ralph Gonzales, MD, a professor at UCSF with deep expertise in implementation science and evaluating innovations within the safety net. Although there are marked racial/ethnic disparities in portal use nationwide, we know little about how to engage diverse patients in utilizing these technologies to extend their care beyond in-person office visits to improve diabetes self-care and management. In Aim 1, we will determine the link between portal use and diabetes outcomes (measured by adherence, missed appointments, and clinical control) among racial/ethnic minority patients at Kaiser. In Aim 2, we will transition to SFGH to qualitatively assess barriers to portal use among diabetes patients, employing user-centered design methodologies. And finally in Aim 3, we will design and test a novel program that addresses patient-reported barriers to use and trains SFGH patients to access the portal as part of their care routine. This work to actively engage a broader and more diverse group of patients in using new health information technology such as portals has the potential to improve health outcomes and reduce overall disparities in care.

描述（由申请人提供）：这是 Courtney Lyles 博士的 K99/R00 奖申请，她是加州大学旧金山分校的健康服务研究员，正在将自己定位为一名年轻的研究者，研究不同糖尿病患者中健康信息技术的使用情况。该奖项将为她提供支持，帮助她转型为独立学术研究员并实现以下目标：1) 成为使用比较有效性研究方法的专家，以了解在线患者门户的使用对少数种族/族裔群体中糖尿病结果的影响，2) 运用定性和实施科学技能来了解门户使用的障碍，并设计一种新的患者参与方法，3) 在具有成熟技术的综合交付系统中应用这些严格的方法。 电子系统（北加州凯撒医疗机构）和安全网公立医院系统目前正在实施在线患者门户（旧金山综合医院，SFGH）。莱尔斯博士组建了一支由医学博士 Dean Schillinger 博士领导的多学科指导团队，Dean Schillinger 博士是设计和严格评估这一安全网环境中创新干预措施的专家。该团队还包括： Andrew Karter 博士，Kaiser 的高级研究员，在种族/民族医疗保健差异和比较有效性方法方面拥有专业知识； Rena Pasick 博士，公共卫生博士，加州大学旧金山分校教授，在了解不同患者偏好和需求的混合方法方面处于全国领先地位； James Ralston 博士，医学博士、公共卫生硕士，团体健康研究所研究员，是患者门户和利用技术设计干预措施以改善糖尿病护理方面的专家；拉尔夫·冈萨雷斯（Ralph Gonzales）博士，医学博士，加州大学旧金山分校教授，在实施科学和安全网创新评估方面拥有深厚的专业知识。 尽管全国范围内门户网站的使用存在明显的种族/民族差异，但我们对如何让不同的患者利用这些技术将他们的护理扩展到亲自办公室就诊之外以改善糖尿病自我护理和管理知之甚少。在目标 1 中，我们将确定 Kaiser 的少数族裔患者的门户网站使用与糖尿病结果（通过依从性、错过预约和临床控制来衡量）之间的联系。在目标 2 中，我们将过渡到 SFGH，采用以用户为中心的设计方法，定性评估糖尿病患者使用门户的障碍。最后，在目标 3 中，我们将设计和测试一个新颖的程序，该程序可解决患者报告的使用障碍，并培训 SFGH 患者访问门户网站，作为其护理常规的一部分。这项工作积极吸引更广泛、更多样化的患者群体使用门户网站等新的健康信息技术，有可能改善健康结果并减少护理方面的总体差异。