Improving healthcare quality with user-centric patient portals

通过以用户为中心的患者门户提高医疗保健质量

• 批准号: 8876535
• 负责人: Jessica S. Ancker
• 金额: $ 15.35万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8876535
• 关键词: Improving; healthcare; quality; user; centric

DESCRIPTION (provided by applicant): Patient-centered care involves respect for patients' values and preferences, coordination across care settings, cultural competency, effective communication, and patient education. To achieve patient-centered care, patients need personalized, timely, and understandable medical information. These needs could potentially be supported by technologies such as electronic patient portals and personal health records, which are likely to become more common in light of the Department of Health and Human Services' 2010 rule to encourage "meaningful use" of health information technology (IT). Consumer health IT has demonstrated efficacy for a number of outcomes, but has not yet demonstrated broad impact on healthcare quality in practice. Models of technology impact suggest that this is because the technologies have not diffused broadly and users are not using them optimally. Barriers to adoption and use include such factors as computer literacy, Internet access, usability, health literacy and numeracy, and sometimes a technology focus on meeting organizational goals rather than patient goals. We propose that potentially beneficial consumer technologies will improve healthcare quality only after they are widely adopted and used, and that adoption will rise only when the technologies match both patient abilities and their needs. We additionally propose that successfully matching technologies to patient needs requires a deeper understanding of patient needs for health information and information management. This proposal describes a research agenda to develop and validate a model of patient information needs, apply it to improve adoption of patient portals, and assess the effect of use of these portals on healthcare quality. The long-term goal of this research is to empower patients to assume a central role in the management of their health and health care, and quantitatively evaluate the effect. The first study described in this proposal uses qualitative methods to develop a patient information management needs framework. The second study validates this framework with quantitative usage data from patient portals. The third study employs human factors methods to improve the portals' usability and ability to meet patient information management needs. The final study will compare quality of care experienced by portal users and nonusers over time. This work, along with the training goals outlined in this proposal, will advance the field of consumer health information technology and position Dr. Jessica Ancker as an independent researcher at the intersection of informatics and health services research.

描述（由申请人提供）：以患者为中心的护理涉及尊重患者的价值观和偏好，协调护理环境，文化能力，有效沟通和患者教育。为了实现以患者为中心的医疗服务，患者需要个性化、及时和易于理解的医疗信息。这些需求可能会得到电子患者门户网站和个人健康记录等技术的支持，根据卫生与公众服务部2010年鼓励“有意义地使用”健康信息技术（IT）的规定，这些技术可能会变得更加普遍。消费者健康信息技术已经证明了对许多结果的有效性，但尚未在实践中证明对医疗质量的广泛影响。技术影响模型表明，这是因为技术没有广泛传播，用户没有最佳地使用这些技术。采用和使用的障碍包括计算机知识、互联网接入、可用性、健康知识和计算能力等因素，有时还包括技术侧重于满足组织目标而不是患者目标。我们认为，只有在广泛采用和使用后，潜在的有益消费者技术才能提高医疗质量，只有当技术与患者的能力和需求相匹配时，采用率才会上升。我们还建议，成功地匹配技术，病人的需求需要更深入地了解病人的健康信息和信息管理的需求。该提案描述了一个研究议程，以开发和验证患者信息需求的模型，将其应用于改善患者门户网站的采用，并评估使用这些门户网站对医疗质量的影响。本研究的长期目标是使患者能够在其健康和医疗保健管理中发挥核心作用，并定量评估其效果。本提案中描述的第一项研究使用定性方法来开发患者信息管理需求框架。第二项研究验证了这一框架与定量使用数据从病人的门户网站。第三项研究采用人为因素的方法来提高门户网站的可用性和满足患者信息管理需求的能力。最终研究将比较门户网站用户和非用户随着时间的推移所经历的护理质量。这项工作，沿着培训目标概述了这一建议，将推进消费者健康信息技术领域和位置杰西卡·安克尔博士作为一个独立的研究人员在信息学和健康服务研究的交叉点。