The impact of patient characteristics on their attitudes toward an online patient portal for communicating laboratory test results: real-world study

Background: Patient portals are promising tools to increase patient involvement and allow them to manage their health. To optimally facilitate patients, laboratory test results should be explained in easy language. Patient characteristics affect the usage of portals and the user satisfaction. However, limited research is available, specified for online communicating laboratory test results, on whether portal use and acceptance differ between groups.Objective: The aim of this study was to assess the effect of patient characteristics (gender, age, education, and chronic disease) on the self-efficacy and perceived usability of an online patient portal that communicates diagnostic test results.Methods: We used the online-administered eHealth impact questionnaire (eHIQ) to explore patients’ attitudes toward the portal. Patients visiting the portal were asked to complete the questionnaire and to answer questions regarding gender, age, education, and chronic disease. The subscale “information and presentation” of the eHIQ assessed the usability of the patient portal and the subscale “motivation and confidence to act” assessed self-efficacy to determine whether patients were motivated to act on the presented information. Age, gender, education, and chronic disease were the determinants to analyze the effect on usability and self-efficacy. Descriptive analyses were performed to explore patient characteristics, usability, and self-efficacy. Univariable and multivariable regression analyses were performed with age, gender, education, and chronic disease as determinants, and usability and self-efficacy as outcomes.Results: The questionnaire was completed by 748 respondents, of which 428 (57.2%) were female, 423 (56.6%) were highly educated, and 509 (68%) had no chronic disease. The mean age was 58.5 years (SD 16.4). Higher age, high education, and asthma or chronic obstructive pulmonary disease were significant determinants for decreased usability; respectively, b=-.094, 95% CI -1147 to 0.042 (PP=.03); and b=-3.630, 95% CI -6.545 to -0.715 (P=.02). High education was also a significant determinant for a lower self-efficacy (b=-3.521, 95% CI -6.469 to -0.572; P=.02). Other determinants were not significant.Conclusions: This study showed that the higher-educated users of a patient portal scored lower on usability and self-efficacy.Usability was also lower for older people and for patients with asthma or chronic obstructive pulmonary disease. The results portal is not tailored for different groups. Further research should investigate which factors from a patient’s perspective are essential to tailor the portal for different groups and how a result portal can be optimally integrated within the daily practice of a doctor.Public Health and primary carePrevention, Population and Disease management (PrePoD

Patients' Attitudes Toward an Online Patient Portal for Communicating Laboratory Test Results: Real-World Study Using the eHealth Impact Questionnaire

Background: Communicating laboratory test results online has several advantages for patients, such as improving clinical efficiency and accessibility, thereby helping patients to take an active role in managing their health.Objective: This study aimed to investigate the experiences and self-efficacy of patients using an online patient portal that communicates laboratory test results.Methods: We used the online-administered eHealth Impact Questionnaire to explore patients' attitudes toward the portal. Patients visiting the portal were asked to complete the questionnaire. The subscale Information and Presentation assessed the usability of the patient portal and the subscale Motivation and Confidence to Act assessed self-efficacy to determine whether patients were motivated to act on the presented information. We used a cutoff score of 65 or greater to determine whether the portal was rated positively.Results: The questionnaire was completed by 354 of 13,907 patients who viewed their laboratory results in the patient portal, with a response rate of 2.55%. The mean Information and Presentation score was 67.70 (SD 13.12) and the mean Motivation and Confidence to Act score was 63.59 (SD 16.22). We found a positive, significant correlation between the 2 subscales (r(345)=.77, P<.001).Conclusions: Patients participating in the study rated the usability of the portal positively. However, the portal only slightly helped patients to take an active role in managing their own health. The low response rate precludes generalization of the results. Future research should examine avenues to further increase patients' self-efficacy and study whether portal acceptability differs in subgroups. Patient portals conveying laboratory test results in understandable language seem usable and potentially provide a viable way to help patients take a more active role in managing their own health.Prevention, Population and Disease management (PrePoD)Public Health and primary car

SERIES: eHealth in primary care. Part 5: a critical appraisal of five widely used eHealth applications for primary care - opportunities and challenges

Background Given the pressure on modern healthcare systems, eHealth can offer valuable opportunities. However, understanding the potential and challenges of eHealth in daily practice can be challenging for many general practitioners (GPs) and their staff. Objectives To critically appraise five widely used eHealth applications, in relation to safe, evidence-based and high-quality eHealth. Using these applications as examples, we aim to increase understanding of eHealth among GPs and highlight the opportunities and challenges presented by eHealth. Discussion eHealth applications can support patients while increasing efficiency for GPs. A three-way division (inform, monitor, track; interaction; data utilisation) characterises many eHealth applications, with an increasing degree of complexity depending on the domain. All applications provide information and some have extra functionalities that promote interaction, while data analysis and artificial intelligence may be applied to support or (fully) automate care processes. Applications in the inform domain are relatively easy to use and implement but their impact on clinical outcomes may be limited. More demanding applications, in terms of privacy and ethical aspects, are found in the data utilisation domain and may potentially have a more significant impact on care processes and patient outcomes. When selecting and implementing eHealth applications, we recommend that GPs remain critical regarding preconditions on safe, evidence-based and high-quality eHealth, particularly in the case of more complex applications in the data utilisation domain.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Stimulation of usage of self-management platforms through integration in disease management

Prevention, Population and Disease management (PrePoD)Public Health and primary car

From chronic disease management to person-centered eHealth; a review on the necessity for blended care

Background: A growing need for structural changes in the organization of the health care system has emerged from the fast-growing number of people with chronic illnesses. eHealth supported self-management programs offer a way to change the traditional approach to person-centered care. Objective: Inclusion and evaluation of the studies e-Vita and PORTALS, which focused on the necessary elements for implementation of eHealth supported self-management for Chronic Obstructive Pulmonary Disease (COPD) and Oral Anticoagulation Therapy (OAT) patients. Summary: Based on this narrative review of the e-Vita COPD study and the PORTALS study, we conclude that eHealth supported self-management integrated into usual care can help patients with COPD and OAT to manage their disease better. We assume that blended care with total integration of eHealth and usual care will provide better quality of care in the long term. While eHealth-supported self-management was not superior to usual care for health status, the studies reported no negative effects, suggesting that eHealth is a safe option for delivery of self-management support and high quality disease management.Usage of the eHealth platforms is better under conditions of perfect integration into usual care and with personal assistance and coaching of patients. The usage is the highest for the patients with platforms that add high practical value to day to day life.The need to educate and coach patients in the use of web-based platforms and to educate healthcare professionals to take a different role, is of great importance. Furthermore, eHealth supported self-management programs need to be offered for a sufficient period to give patients the chance to change their behavior, and finally achieve a better health status. Implications for future research and clinical practice: More studies are needed (preferably with larger sample groups, and including non-users) to gain more insight into the optimal combination of usual care and eHealth based self-management, the preferences and needs of various patients, the necessary education for healthcare professionals and patients, the best platform for patients that is easy to use, as well as the related costs

Een online portaal voor het communiceren van uitslagen van bloedonderzoek. Webrapportage: een experiment met het Saltro uitslagenportaal.

Er komen in de gezondheidszorg steeds meer online patiëntportalen voor verschillende doeleinden. Eén van de online portalen is het uitslagenportaal van Saltro. Dit portaal heeft tot doel de laboratoriumuitslagen snel door te geven aan patiënten zonder dat zij daarvoor naar de huisartspraktijk hoeven. Voorbeelden van testen waarvan de uitslagen via het portaal doorgegeven worden, zijn testen op bloedarmoede, schildklierhormoon of op het vitamine D gehalte. Patiënten van huisartsen die aangesloten zijn bij het portaal kunnen gebruik maken van deze dienst. Saltro is niet de enige instantie met een uitslagenportaal. Wat het uitslagenportaal van Saltro onderscheidt van veel andere portalen, is de uitgebreidere ondersteuning die het biedt aan patiënten bij het lezen van de uitslagen. De uitslag van een test kan worden weergegeven als één cijfer met daarbij de zogeheten referentiewaarden: een interval, waarbinnen de uitkomst van de uitgevoerde test 'hoort te vallen'. Wanneer de uitslag binnen dit interval valt, wordt de uitslag “niet afwijkend” genoemd. Het portaal van Saltro helpt de gebruiker om in te zien of zijn of haar waarden al dan niet afwijkend zijn en wat dit betekent voor hun gezondheid. Dit wordt gedaan door de uitslag in kleuren weer te geven. Daarbij staat groen voor een niet-afwijkende uitslag. Afwijkende uitslagen worden, afhankelijk van de grootte van de afwijking, in oranje of rood weergegeven. Naast deze visuele ondersteuning biedt het portaal van Saltro ook tekst en uitleg bij de uitslagen. In dit onderzoek keken we of de combinatie van visuele ondersteuning en de tekstuele uitleg meerwaarde heeft voor de patiënt. We vergeleken daartoe het Saltro portaal met een fictief portaal dat geen ondersteuning biedt. (aut. ref.

Features of a Patient Portal for Blood Test Results and Patient Health Engagement:Web-Based Pre-Post Experiment

Background: The use of patient portals for presenting health-related patient data, such as blood test results, is becoming increasingly important in health practices. Patient portals have the potential to enhance patient health engagement, but content might be misinterpreted. Objective: This study aimed to discover whether the way of presenting blood test outcomes in an electronic patient portal is associated with patient health engagement and whether this varies across different blood test outcomes. Methods: A 2x3 between-subjects experiment was conducted among members of the Nivel Dutch Health Care Consumer Panel. All participants read a scenario in which they were asked to imagine themselves receiving blood test results. These results differed in terms of the presented blood values (ie, normal vs partially abnormal vs all abnormal) as well as in terms of whether the results were accompanied with explanatory text and visualization. Patient health engagement was measured both before (T0) and after (T1) participants were exposed to their fictive blood test results. Results: A total 487 of 900 invited members responded (response rate 54%), of whom 50.3% (245/487) were female. The average age of the participants was 52.82 years (SD 15.41 years). Patient health engagement saw either a significant decrease or a nonsignificant difference in the experimental groups after viewing the blood test results. The mean difference was smaller in the groups that received blood test results with additional text and visualization (meanT0 5.33, SE 0.08; meanT1 5.14, SE 0.09; mean difference 0.19, SE 0.08, P=.02) compared with groups that received blood test results without explanatory text and visualization (meanT0 5.19, SE 0.08; meanT1 4.55, SE 0.09; mean difference 0.64, SE 0.08, P&lt;.001). Adding text and visualization, in particular, reduced the decline in patient health engagement in participants who received normal results or mixed results (ie, combination of normal and abnormal results). Conclusions: Adding text and visualization features can attenuate the decrease in patient health engagement in participants who receive outcomes of a blood test via a patient portal, particularly when blood test results are (partly) normal. This suggests that explanatory text and visualization can be reassuring. Future research is warranted to determine whether these results can be generalized to a patient population who receive their actual blood test results.</p