Patient portals

Patient portals can give patients access to a personal health record and enable interaction with the health care system. Patient portals are creating unprecedented opportunities for using health IT to deliver care to patients, paving the way for benefits to patients, providers and the organizations that implement the portals. The objective of this dissertation has been to explore the role of the organizational context by identifying and describing factors affecting portals in different types of health service systems. We have let the following four questions guide the research. 1. What outcomes have been achieved through patient portals and how are these outcomes achieved? 2. How does the health service system context, in particular health service system integration or fragmentation, impact patient portal development and ability to achieve beneficial outcomes? 3. With focus on fragmented health service systems, how can patient portal development and achievement of beneficial outcomes be improved? 4. How can the existing evidence base inform patient portal development across health service systems and how can this evidence base be advanced? In answering these questions, we studied portals in integrated and fragmented health service systems in the United States and in the Netherlands. We relied on multiple qualitative methods, including literature review, document analysis, and interviews

The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: a qualitative study of Kaiser Permanente.

BackgroundPatient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However, despite growing research on patient portals and their effects, our understanding of the organizational dynamics that explain how effects come about is limited.MethodsThis paper uses qualitative methods to advance our understanding of the organizational dynamics that influence the impact of a patient portal on organizational performance and patient health. The study setting is Kaiser Permanente, the world's largest not-for-profit integrated delivery system, which has been using a portal for over ten years. We interviewed eighteen physician leaders and executives particularly knowledgeable about the portal to learn about how they believe the patient portal works and what organizational factors affect its workings. Our analytical framework centered on two research questions. (1) How does the patient portal impact care delivery to produce the documented effects?; and (2) What are the important organizational factors that influence the patient portal's development?ResultsWe identify five ways in which the patient portal may impact care delivery to produce reported effects. First, the portal's ability to ease access to services improves some patients' satisfaction as well as changes the way patients seek care. Second, the transparency and activation of information enable some patients to better manage their care. Third, care management may also be improved through augmented patient-physician interaction. This augmented interaction may also increase the 'stickiness' of some patients to their providers. Forth, a similar effect may be triggered by a closer connection between Kaiser Permanente and patients, which may reduce the likelihood that patients will switch health plans. Finally, the portal may induce efficiencies in physician workflow and administrative tasks, stimulating certain operational savings and deeper involvement of patients in medical decisions. Moreover, our analysis illuminated seven organizational factors of particular importance to the portal's development--and thereby ability to impact care delivery: alignment with financial incentives, synergy with existing IT infrastructure and operations, physician-led governance, inclusive decision making and knowledge sharing, regional flexibility to implementation, continuous innovation, and emphasis on patient-centered design.ConclusionsThese findings show how organizational dynamics enable the patient portal to affect care delivery by summoning organization-wide support for and use of a portal that meets patient needs

Nøgletal for miljøfarlige stoffer i spildevand fra renseanlæg - på baggrund af data fra det nationale overvågningsprogram for punktkilder 1998-2009

__Abstract__ De inzet van eHealth, een verzamelbegrip voor informatie- en communicatietechnologieën in de zorg, kan bijdragen bij het faciliteren en borgen van veranderingen in de zorgverlening die noodzakelijk lijken om de groeiende zorgvraag op te vangen. Vanuit samenwerkingsverbanden tussen zorginstellingen en ICT-leveranciers zijn er in de afgelopen jaren veel eHealth-initiatieven in Nederland ontplooid, waaronder een groot aantal nieuwe internetportalen voor zorg, welzijn en gezondheid. Regionale patiëntportalen zijn een voorbeeld van dergelijke portalen, die zich van andere portalen onderscheiden door het samenbrengen van informatie en diensten voor inwoners van een bepaald (vooral geografisch) gebied. Omdat de ontwikkelin

Characteristics of patient portals developed in the context of health information exchanges: Early policy effects of incentives in the meaningful use program in the United States

__Background:__ In 2014, the Centers for Medicare & Medicaid Services in the United States launched the second stage of its Electronic Health Record (EHR) Incentive Program, providing financial incentives to providers to meaningfully use their electronic health records to engage patients online. Patient port

The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: A qualitative study of Kaiser Permanente

Background: Patient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However, despite growing research on patient portals and their effects, our understanding of the organizational dynamics that explain how effects come about is limited. Methods

Can relational coordination help inter-organizational networks overcome challenges to coordination in patient portals?

Purpose: Delivering comprehensive patient portals in fragmented delivery systems depends on coordination among a network of healthcare organizations. Inter-organizational coordination is fraught with challenges, mainly due to a lack of organizational, technological, and geographical proximity between network participants. This paper assesses the extent to which application of Relational Coordination Theory (RCT) can ameliorate these challenges. Approach: We conducted a conceptual analysis of the usefulness of RCT and the applicability of the Relational Model of Organizational Change to patient portal networks. Findings: Relational coordination can mitigate challenges caused by lack of organizational and technological proximity among participants in a patient portal network. The Relational Model of Organizational Change is useful to improve relational coordination. However, some organization redesign interventions proposed in the Model may not be directly applicable to patient portal networks due to lack of geographical proximity among network participants. Conclusion: We suggest three propositions regarding the relationships among relational coordination, organizational and technological proximity, and cost of coordination in an inter-organizational portal network. If future research provides empirical support for these propositions and identifies appropriate adaptations of the Relational Model of Organizational Change for inter-organizational contexts, portal network leaders should strive to strengthen relational coordination in their networks