Consumers\u27 Perceptions of Patient-Accessible Electronic Medical Records

Background: Electronic health information (eHealth) tools for patients, including patient-accessible electronic medical records (patient portals), are proliferating in health care delivery systems nationally. However, there has been very limited study of the perceived utility and functionality of portals, as well as limited assessment of these systems by vulnerable (low education level, racial/ethnic minority) consumers. Objective: The objective of the study was to identify vulnerable consumers’ response to patient portals, their perceived utility and value, as well as their reactions to specific portal functions. Methods: This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June and July 2010, in New York City. Results: Participants included 10 males and 18 females, ranging in age from 21-63 years; 19 non-Hispanic black, 7 Hispanic, 1 non-Hispanic White and 1 Other. None of the participants had higher than a high school level education, and 13 had less than a high school education. All participants had experience with computers and 26 used the Internet. Major themes were enhanced consumer engagement/patient empowerment, extending the doctor’s visit/enhancing communication with health care providers, literacy and health literacy factors, improved prevention and health maintenance, and privacy and security concerns. Consumers were also asked to comment on a number of key portal features. Consumers were most positive about features that increased convenience, such as making appointments and refilling prescriptions. Consumers raised concerns about a number of potential barriers to usage, such as complex language, complex visual layouts, and poor usability features. Conclusions: Most consumers were enthusiastic about patient portals and perceived that they had great utility and value. Study findings suggest that for patient portals to be effective for all consumers, portals must be designed to be easy to read, visually engaging, and have user-friendly navigation

The role of Mediterranean mesoscale eddies on the climate of the Euro-Mediterranean region

Within the CIRCE (Climate Change and Impact Research: The Mediterranean Environment) EU Project, substantial efforts were devoted to enhance the representation of the oceanic system in the Mediterranean region. This was achieved by developing coupled general circulation models with ocean components which either explicitly resolve, or simply permit, mesoscale circulation features. The inclusion of the eddy variability tail in the spectrum of the processes resolved by the modelled system represents a particularly relevant step forward with respect to the previous CMIP3 generation of climate models , as these were systematically based on coarse resolution ocean components, leading in turn to an extremely rough representation of the Mediterranean Sea sub-system. In this study the role of mesoscale oceanic features on the air-sea interactions over the Mediterranean region was analysed, in the context of one of the CIRCE ensemble of climate models. To this aim, two different simulations of the 20th Century climate, performed with two distinct configurations of the CMCC coupled general circulation model featuring radically different horizontal resolutions in the Mediterranean Sea domain, were compared. This comparison highlights the implications deriving from the inclusion of energetic ocean mesoscale structures in the variability spectrum of the coupled ocean-atmosphere system and points to the need for high-resolution ocean components in the development of next generation climate model