Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 10, 2019
Open Peer Review Period: Jan 14, 2019 - Mar 11, 2019
Date Accepted: May 10, 2019
(closed for review but you can still tweet)
Patient Activation and the Use of Acute Care Patient Portals
ABSTRACT
Background:
Health information technology (HIT) tools and patient portals are recognized as a potential mechanism to facilitate patient engagement and patient-centered care, yet the use of these tools remains limited in the hospital setting. While research in this area is growing, it is unclear how the use of acute care patient portals and patient-centered HIT tools might affect outcomes such as patient activation.
Objective:
The aim was to describe use of an acute care patient portal and investigate the association of HIT tools in the inpatient setting with patient and care partner activation.
Methods:
We implemented a suite of electronic tools including a patient portal, bedside safety display, and provider-facing safety dashboard on six acute care units over an 18-month period. We compared patient characteristics of those that enrolled to the patient portal and those that declined. Patient and care partner use of the portal was evaluated, and patient and care partner activation was assessed using the short-form of the Patient Activation Measure.
Results:
1,755 (59%) agreed to participate and use the patient portal. Patients that declined were older, sicker, more likely to have Medicare as their insurer, and less likely to use the enterprise patient portal. The most used features of the patient portal were the laboratory test results, care team information, and medications list. Most users accessed the portal between 1-4 days (range 1-32 days) during their hospitalization, and the average number of days used (logged in at least once per day) was 1.8 days. On average, users accessed the portal 42.7% of the hospital days it was available. There was significant improvement in patient activation on the neurology service (P <.0001) and medicine service (P = .01) after the introduction of patient and provider-facing HIT tools and use of a patient portal, but not on the oncology service.
Conclusions:
We found an association between use of patient and provider-facing HIT tools including a patient portal and improved levels of patient activation in inpatients. These tools may help facilitate patient engagement and improve outcomes. Future work should leverage usage metrics to describe inpatient portal use and assess the impact of HIT tools on specific outcome measures in the hospital setting.
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.