Health Information Technology (HIT) Experiences Of The Person With Heart Failure: A Descriptive Interpretive Phenomenological Mini Study

Sufficient research has been conducted to explore the lived experience of the person with heart failure. Gap in the knowledge is in regards to the lived experience of those with repeated hospitalizations and their use of health information technology (HIT) which can support self management. Purpose of this project is to describe the lived experience of using HIT by the person with heart failure who has been readmitted to the hospital within the previous six months

Patient Portal Use in a Community Medical Group: A Healthcare Improvement Project

The American Recovery and Reinvestment Act (ARRA) of 2009 included the Health Information Technology for Economic and Clinical Health Act (HITECH) to provide stimulus for the provision of electronic access for consumers as a way to improve patient engagement. As described by the act, meaningful use of a tethered personal health record called a patient portal was theorized to improve patient engagement and result in improved clinical outcomes, reduced cost and increased patient satisfaction. Accordingly, financial incentives and penalties were to be awarded the eligible provider (EP) demonstrating meaningful use according to various stages with corresponding deadlines. A community medical group is striving to receive the financial incentives for meaningful use as well as address the national initiatives to improve patient engagement with the use of a patient portal. The global aim of this two part research translation and healthcare improvement project is to promote patient engagement by identifying the factors that affect a patients’ decision to use a patient portal as well as to identify potential strategies to promote portal use. Phase I of the project involved surveying both patient portal users (n=235) and non-users (n=36) to determine the presence of any barriers or facilitators. The survey was based on the Health Information Technology Acceptance Model by Kim and Park (2012). In addition, baseline patient engagement was assessed using the Patient Activation Measure (PAM®). When comparing portal users to non-users with respect to the HITAM model variables, differences were identified in the perception of usefulness as well as the related outcomes of attitude and intent to use the technology. In addition, if a patient perceives that the patient portal is useful, they are 1.44 times more likely to register and use a patient portal. There were no differences in patient engagement levels between portal users and non-users. In Phase II, the data analysis guided the selection of an intervention, a pilot of Open Notes by volunteer community medical group providers as a strategy to possibly increase the percentage of patients who access and use the patient portal. Patient perceptions as to benefits and risks of viewing their office visit note will guide facility decisions to optimize portal use

Patient Portal Use, Health Information Technology Self-Efficacy, Electronic Health Literacy, and Self-Management among Patients with Heart Failure: A Cross Sectional Study

Background: By the year 2030, the prevalence of heart failure (HF) is anticipated to rise by 46%, impacting over 8 billion persons. Self-management of HF is key to maintaining a healthy lifestyle and quality of life. Yet many have sub-optimal self-management skills necessitating innovative strategies to enhance self-management. An innovative strategy to support the person with HF is the use of health information technology (HIT) such as a patient portal (PP). Additionally, self-efficacy and health literacy are important to self-management of HF. Further understanding is needed of the relationship between PP use, HIT self-efficacy (HIT SE), electronic health literacy (eHL) and self-management among persons with HF. Objective: To describe patient portal use among persons with HF, explore differences in PP use based on demographic characteristics, and examine associations between the key variables of PP use, HIT SE, eHL, and self-management of HF. Methods: A cross sectional design with an anonymous electronic survey was used to collect data on: demographics, the Self-Assigned New York Heart Association Classification (SA-NYHA), PP use, HIT SE, eHL, and self-management as measured by the Self-Care Heart Failure Index (SCHFI). Self-report data from a convenience sample from three facilities in the Northeastern United States was explored using descriptive statistical analysis, Chi Square tests of independence, and a Kruskal-Wallis/Jonckheere Terpstra analysis. Results: Among persons with an active diagnosis of HF who were registered for their PP (N=20), 90% were \u3e60 years, and 95% were diagnosed within the previous decade; 75% classified themselves as Class I/II according to the SA-NYHA. Sufficient HIT SE (M= 23.3, SD=4.2) and eHL (M=31.1, SD=5.4) was reported. Sixty percent reported using the messaging feature while SD=22.0). Conclusion: This small sample reported sufficient HIT SE and eHL, yet only 35% were active PP users, and use of PP features was limited. Finally, there remains an opportunity to support self-management of HF