Effects of Patient Portal Use on Patient Satisfaction: Survey and Partial Least Squares Analysis.
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ABSTRACT: Background
With digital delivery of health care services gaining prominence, patient portals have become a mainstay of many health care organizations. Despite the importance of patient portals, inconclusive data exist regarding the effect of patient portal use on patient satisfaction.Objective
The aim of this study is to understand the relationship between the postadoptive use of patient portals and patient satisfaction outcomes.Methods
Postadoptive use of patient portals has a positive relationship with the 3 dimensions of patient satisfaction, mediated by gratification, health self-awareness, and health perceptions. A total of 504 valid patient portal user responses were collected, and partial least squares analysis was performed to analyze the data.Results
Patient satisfaction was captured using three dimensions: care team interaction, atmosphere, and instruction effectiveness. The results show that postadoptive use of patient portals has a positive influence on all 3 dimensions of patient satisfaction through the mediating variables of gratification, health self-awareness, and health perceptions. Specifically, postadoptive use had significant positive influence on gratification, health self-awareness, and health perceptions. Each of the 3 patient perceptions had significant positive influence on all 3 dimensions of patient satisfaction: care team interaction, atmosphere, and instruction effectiveness. Specifically, our model explained 31.8% of the care team interaction, 40.6% of the atmosphere, and 39.1% of the instruction effectiveness.Conclusions
Our model shows that patient portal use can influence patient satisfaction through the mediating effects of gratification, health self-awareness, and health perception. Patient satisfaction is an important outcome for health care organizations. Therefore, by promoting effective patient portal use and fostering patient perceptions, health care organizations can improve patient satisfaction.
SUBMITTER: Kinney AP
PROVIDER: S-EPMC8433860 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Although electronic medical record (EMR)-tethered patient portals are common in other countries, they are still emerging in Canada. OBJECTIVE:We aimed to report user satisfaction and the effects of a patient portal on medical appointment attendance in a Canadian cohort of patients within our publicly funded health care system. METHODS:Two surveys were deployed, via email, at 2 weeks and 6 months following the first recorded patient portal access. Database audits of visit attendance were used to supplement and cross reference survey data. RESULTS:Between January 2016 and July 2018, 4296 patients accessed the patient portal. During the study, 28% (957/3421) consented patient portal users responded to one or more semistructured electronic surveys. Of respondents, 93% (891/957) reported that the patient portal was easy to use, 51% (492/975) reported it saved time when scheduling an appointment, and 40% (382/957) reported that they had to repeat themselves less during appointments. Respondents reported patient portal-related changes in health system use, with 48% (462/957) reporting avoiding a clinic visit and 2.7% (26/957) avoiding an emergency department visit. Across 19,968 visits in clinics where the patient portal was introduced, missed appointments were recorded in 9.5% (858/9021) of non-patient portal user visits, compared with 4.5% (493/9021) for patient portal users, representing a 53% relative reduction in no-show rates. CONCLUSIONS:Early experience with an EMR-tethered patient portal showed strong reports of positive patient experience, a self-reported decrease in health system use, and a measured decrease in missed appointment rates. Implications on the expanded use of patient portals requires more quantitative and qualitative study in Canada.
| S-EPMC7267992 | biostudies-literature
Project description:BackgroundPatient portals have been introduced in several countries in the last few decades. Despite worldwide objectives of introducing patient portals, nationwide portals are rare, and studies about their use are limited. Finland is one of the forerunners in developing nationwide health data systems. A nationwide patient portal, My Kanta, for viewing electronic prescriptions and health data has been phased in, starting in 2010.ObjectiveThe aim of this study was to investigate what functions Finnish pharmacy customers use in My Kanta, their perceptions of the service's usability, and how satisfied users are with My Kanta overall.MethodsIn spring 2019, questionnaires (N=2866) were distributed from 18 pharmacies of varying size across mainland Finland to adult pharmacy customers purchasing prescription medications for themselves or for their child under 18 years of age. Questions were asked about the use and usability of the patient portal by means of structured and Likert-scale questions. Statistical analyses included frequencies, means, medians, chi-square tests, Fisher exact tests, and Kruskal-Wallis tests.ResultsIn total, 994 completed questionnaires of 2866 delivered questionnaires (34.68%) were returned. The most-used My Kanta functions were browsing prescription information (781/802, 97.4%), records of health care visits (772/802, 96.3%), and results of laboratory tests and x-ray examinations (722/804, 89.8%). Most users (558/793, 70.4%) had also requested a prescription renewal using the service. My Kanta was perceived as easy to log into (772/816, 94.6%) and clear to view (709/808, 87.7%). Most users considered the service useful for monitoring their health information (753/813, 92.6%) and felt that it provides a good overall picture of the medications prescribed to them (711/813, 87.5%). The majority of users found the information recorded about them easy to understand (684/800, 85.5%). Of the users, 16.7% (135/807) disagreed with the statement that the information they were looking for was easy to find. Approximately two-thirds (501/814, 61.5%) of users did not know whether it is easy to view in which pharmacies and health care units their prescription information has been viewed, and over one-third (306/805, 38.0%) did not know whether it is easy to view in which health care units their health information has been processed. Approximately one-fifth of participants (181/805, 22.5%) feared that unauthorized persons might view their information and that their electronically saved prescription and health information might disappear (180/810, 22.2%). In addition, 16.1% (129/799) expressed interest in receiving guidance on My Kanta use. The vast majority of users (719/804, 89.4%) were satisfied with the service overall.ConclusionsPharmacy customers were satisfied with the nationwide patient portal. It was mostly used for browsing e-prescriptions and medical records. Overall, the usability of the service was good. However, users need to be better informed about data privacy and security issues, and guidance on using the portal needs to be improved.
| S-EPMC8325076 | biostudies-literature
Project description:Many physicians are adopting patient portals in response to governmental incentives for meaningful use (MU), but the stage 2 requirements for portal use may be particularly challenging for newer electronic health record (EHR) users. This study examined enrollment, use based on MU requirements, and satisfaction in a recently adopting fee-for-service multispecialty system. Between 2010 and 2012, overall portal enrollment increased from 13.2% to 23.1% but varied substantially by physician specialty. In 2013, more than 97% of physicians would have met requirements for a stage 2 MU utilization measure requiring that patients download personal health information, but only 38% of all physicians (87% of primary care physicians [PCPs] and 37% of other specialists) would have met e-mail requirements. Satisfaction with the portal overall and with portal-based e-mails was high. These results suggest that later-adopting PCPs can succeed in providing satisfactory record and e-mail access but specialists may find reaching e-mail thresholds more difficult.
| S-EPMC4141030 | biostudies-literature
Project description:BackgroundPatient-facing health information technology (HIT) tools, such as patient portals, are recognized as a potential mechanism to facilitate patient engagement and patient-centered care, yet the use of these tools remains limited in the hospital setting. Although research in this area is growing, it is unclear how the use of acute care patient portals might affect outcomes, such as patient activation.ObjectiveThe aim of this study was to describe the use of an acute care patient portal and investigate its association with patient and care partner activation in the hospital setting.MethodsWe implemented an acute care patient portal on 6 acute care units over an 18-month period. We investigated the characteristics of the users (patients and their care partners) of the patient portal, as well as their use of the portal. This included the number of visits to each page, the number of days used, the length of the user's access period, and the average percent of days used during the access period. Patient and care partner activation was assessed using the short form of the patient activation measure (PAM-13) and the caregiver patient activation measure (CG-PAM). Comparisons of the activation scores were performed using propensity weighting and robust weighted linear regression.ResultsOf the 2974 randomly sampled patients, 59.01% (1755/2974) agreed to use the acute care patient portal. Acute care patient portal enrollees were younger, less sick, less likely to have Medicare as their insurer, and more likely to use the Partners Healthcare enterprise ambulatory patient portal (Patient Gateway). The most used features of the acute care patient portal were the laboratory test results, care team information, and medication list. Most users accessed the portal between 1 to 4 days during their hospitalization, and the average number of days used (logged in at least once per day) was 1.8 days. On average, users accessed the portal 42.69% of the hospital days during which it was available. There was significant association with patient activation on the neurology service (P<.001) and medicine service (P=.01), after the introduction of HIT tools and the acute care patient portal, but not on the oncology service.ConclusionsPortal users most often accessed the portal to view their clinical information, though portal usage was limited to only the first few days of enrollment. We found an association between the use of the portal and HIT tools with improved levels of patient activation. These tools may help facilitate patient engagement and improve outcomes when fully utilized by patients and care partners. Future study should leverage usage metrics to describe portal use and assess the impact of HIT tools on specific outcome measures in the hospital setting.
| S-EPMC6670280 | biostudies-literature
Project description:ObjectiveWe sought to measure patient portal satisfaction with patient portals and characterize its relationship to attitude towards computers, health literacy, portal usage, and patient demographics.Materials and methodsWe invited 13 040 patients from an academic medical center to complete a survey measuring satisfaction, perceived control over computers, and health literacy using validated instruments (End User Computing Satisfaction, Computer Attitude Measure, and Brief Health Literacy Screen). We extracted portal usage and demographic information from the medical center data warehouse.ResultsA total of 6026 (46.2%) patients completed the survey. The median (IQR) scores for satisfaction, computer control, and health literacy were 87% (20%), 86% (22%), and 95% (15%), respectively. The normalized mean (SD) usage of messaging, lab, appointment, medication, and immunization functions were 6.6 (2.6), 4.6 (2.4), 3.1 (1.7), 1.5 (1.2), and 0.88 (0.91) times, respectively. Logistic regression yielded significant odds ratios [99% CI] for computer control (3.6 [2.5-5.2]), health literacy (12 [6.9-23]), and immunization function usage (0.84 [0.73-0.96]).DiscussionRespondents were highly satisfied and had high degrees of computer control and health literacy. Statistical analysis revealed that higher computer control and health literacy predicted higher satisfaction, whereas usage of the immunization function predicted lower satisfaction. Overall, the analytical model had low predictive capability, suggesting that we failed to capture the main drivers of satisfaction, or there was inadequate variation in satisfaction to delineate its contributing factors.ConclusionThis study provides insight into patient satisfaction with and usage of a patient portal. These data can guide the development of the patient portal, with the ultimate goal of increasing functionality and usability to enhance the patient experience.
| S-EPMC6994001 | biostudies-literature
Project description:BackgroundPreventive and therapeutic options for renal failure are still limited. Gene expression profile analysis is powerful in the identification of biological differences between end stage renal failure patients and healthy controls. Previous studies mainly used variance/regression analysis without considering various biological, environmental factors. The purpose of this study is to investigate the gene expression difference between end stage renal failure patients and healthy controls with partial least squares (PLS) based analysis.MethodsWith gene expression data from the Gene Expression Omnibus database, we performed PLS analysis to identify differentially expressed genes. Enrichment and network analyses were also carried out to capture the molecular signatures of renal failure.ResultsWe acquired 573 differentially expressed genes. Pathway and Gene Ontology items enrichment analysis revealed over-representation of dysregulated genes in various biological processes. Network analysis identified seven hub genes with degrees higher than 10, including CAND1, CDK2, TP53, SMURF1, YWHAE, SRSF1, and RELA. Proteins encoded by CDK2, TP53, and RELA have been associated with the progression of renal failure in previous studies.ConclusionsOur findings shed light on expression character of renal failure patients with the hope to offer potential targets for future therapeutic studies.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1450799302127207.
| S-EPMC4104724 | biostudies-literature
Project description:BackgroundPatient access to their medical records through patient portals (PPs) facilitates information exchange and provision of quality health care. Understanding factors that characterize patients with limited access to and use of PPs is needed.MethodsData were from the 2017-2018 Health Information National Trends Survey 5, Cycles 1 and 2, a nationally representative survey of US adults ≥ 18 years old (n = 6789). Weighted multivariate logistic regressions modeled the associations between patient characteristics and access to, facilitators of use, and use of PPs and their functions.ResultsIndividuals without (vs with) a regular doctor (adjusted odds ratio [aOR], 0.4; CI, 0.3-0.5) or health insurance (aOR, 0.4; CI, 0.2-0.7), those with high school (aOR 0.4; CI, 0.3-0.5) or with vocational/some college (aOR, 0.5; CI, 04.-0.7) education (vs college/postgraduate), or those with limited English proficiency (vs those who speak English very well) (aOR, 0.7; CI, 0.5-0.9) were less likely to report accessing their personal medical records. Women (vs men) were more likely to report accessing their medical records (aOR, 1.5; CI, 1.2-1.8). Similar patterns were found for PPs access and facilitators of use. Less consistent associations emerged between patient characteristics and use of PP functionalities.ConclusionsPP access and use are low. Having a primary care clinician, patient's educational attainment, and being a woman were factors associated with PP access and use, but not race/ethnicity. Once access was achieved, use of PP functionalities was generally uniform across demographic segments. Facilitating PP access and use among all patient populations is warranted.
| S-EPMC7849369 | biostudies-literature
Project description:Purpose/objectivesTo identify nursing staff reactions to and perceptions of electronic portal use in a cancer setting.
.Research approachQualitative.
.SettingOutpatient clinic at the Harold C. Simmons Comprehensive Cancer Center of the University of Texas Southwestern Medical Center in Dallas.
.Participants13 nurses with a range of credentials and experience, representing infusion, medical oncology, and bone marrow transplantation clinics.
.Methodologic approachTwo focus groups were conducted. Theoretical thematic content analysis of data was performed.
.FindingsKey themes that emerged for consideration of electronic portals included work volume and flow, patient expectations and safety, variation in use of communication technologies, and education and management.
.InterpretationThe current study provides insight into the implications of electronic portals by identifying nursing staff reactions to this technology. These reactions are predominantly related to the impact on clinical workload and patient safety and expectations.
.Implications for nursingAs clinical cancer facilities incorporate electronic portal technology into their operations, attention to the impact on staff workload, division of labor, patient safety, and patient expectations should be considered.
| S-EPMC7066859 | biostudies-literature
Project description:BackgroundIn recent literature, patient portals are considered as important tools for the delivery of patient-centered care. To date, it is not clear how patients would conceptualize a patient portal and which health information needs they have when doing so.ObjectiveThis study aimed (1) to investigate health information needs, expectations, and attitudes toward a patient portal and (2) to assess whether determinants, such as patient characteristics, health literacy, and empowerment status, can predict two different variables, namely the importance people attribute to obtaining health information when using a patient portal and the expectations concerning personal health care when using a patient portal.MethodsWe conducted a cross-sectional survey of the Flemish population on what patients prefer to know about their digital health data and their expectations and attitudes toward using a patient portal to access their electronic health record. People were invited to participate in the survey through newsletters, social media, and magazines. We used a questionnaire including demographics, health characteristics, health literacy, patient empowerment, and patient portal characteristics.ResultsWe received 433 completed surveys. The health information needs included features such as being notified when one's health changes (371/396, 93.7%), being notified when physical parameters increase to dangerous levels (370/395, 93.7%), observing connections between one's symptoms or diseases or biological parameters (339/398, 85.2%), viewing the evolution of one's health in function of time (333/394, 84.5%), and viewing information about the expected effect of treatment (349/395, 88.4%). Almost 90% (369/412) of respondents were interested in using a patient portal. Determinants of patients' attachment for obtaining health information on a patient portal were (1) age between 45 and 54 years (P=.05); (2) neutral (P=.03) or interested attitude (P=.008) toward shared decision making; and (3) commitment to question physicians' decisions (P=.03, R2=0.122). Determinants of patients' expectations on improved health care by accessing a patient portal were (1) lower education level (P=.04); (2) neutral (P=.03) or interested attitude (P=.008) toward shared decision making; and (3) problems in understanding health information (P=.04; R2=0.106).ConclusionsThe interest in using a patient portal is considerable in Flanders. People would like to receive alerts or some form of communication from a patient portal in case they need to act to manage their health. Determinants such as education, attached importance to shared decision making, difficulties in finding relevant health information, and the attached importance in questioning the decisions of physicians need to be considered in the design of a patient portal.
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Project description:In metabolomics, identification of metabolic pathways altered by disease, genetics, or environmental perturbations is crucial to uncover the underlying biological mechanisms. A number of pathway analysis methods are currently available, which are generally based on equal-probability, topological-centrality, or model-separability methods. In brief, prior identification of significant metabolites is needed for the first two types of methods, while each pathway is modeled separately in the model-separability-based methods. In these methods, interactions between metabolic pathways are not taken into consideration. The current study aims to develop a novel metabolic pathway identification method based on multi-block partial least squares (MB-PLS) analysis by including all pathways into a global model to facilitate biological interpretation. The detected metabolites are first assigned to pathway blocks based on their roles in metabolism as defined by the KEGG pathway database. The metabolite intensity or concentration data matrix is then reconstructed as data blocks according to the metabolite subsets. Then, a MB-PLS model is built on these data blocks. A new metric, named the pathway importance in projection (PIP), is proposed for evaluation of the significance of each metabolic pathway for group separation. A simulated dataset was generated by imposing artificial perturbation on four pre-defined pathways of the healthy control group of a colorectal cancer study. Performance of the proposed method was evaluated and compared with seven other commonly used methods using both an actual metabolomics dataset and the simulated dataset. For the real metabolomics dataset, most of the significant pathways identified by the proposed method were found to be consistent with the published literature. For the simulated dataset, the significant pathways identified by the proposed method are highly consistent with the pre-defined pathways. The experimental results demonstrate that the proposed method is effective for identification of significant metabolic pathways, which may facilitate biological interpretation of metabolomics data.
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