Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 2, 2019
Open Peer Review Period: Apr 5, 2019 - May 31, 2019
Date Accepted: Aug 19, 2019
(closed for review but you can still tweet)
Patient Recommendations to Improve Implementation and Engagement with Portals in Acute Care: a hospital-based, mixed-methods study
ABSTRACT
Background:
Inpatient implementation of portals to the Electronic Health Record lags behind outpatient settings and the literature on patient preferences for engagement with portals in the hospital is limited.
Objective:
We sought to understand patient-reported barriers and facilitators to engagement during an episode of acute care using mixed methods with a large, diverse sample of hospitalized patients.
Methods:
We utilized a mixed-methods approach to explore patient experiences using the portal during hospitalization. All patients received a tablet with brief tutorial, pre/post-use surveys, and completed in-person, semi-structured interviews. Qualitative data were coded using thematic analysis to iteratively develop 18 codes which were integrated into 3 themes framed as patient recommendations to hospitals to improve engagement with the portal during acute care. Themes from this qualitative data guided our approach to analysis of quantitative data.
Results:
We enrolled 97 participants: 53 (55%) women, 44 (45%) non-white, average age 48 (19-81), average length of hospitalization was 6.4 days. Forty-seven (48%) had an active portal account, 59 (57%) owned a smartphone, and 79 (81%) accessed the internet daily. Three overarching themes emerged from qualitative analysis of interviews with these patients during their hospital stay: 1) Hospitals should provide both access to a device and Bring-Your-Own-Device (BYOD) platform to access the portal; 2) Hospitals should provide an orientation both on how to use the device and how to use the portal; 3) Hospitals should ensure portal content is up-to-date and easy to understand.
Conclusions:
Patients independently and consistently identified basic needs for device and portal access, education, and usability. Hospitals should prioritize these areas to enable successful implementation of inpatient portals to promote greater patient engagement during acute care. Clinical Trial: NCT01970852
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.