This appeared last week:
Patient portal usage associated with better preventive health engagement
October 08, 2019, 11:06 p.m. EDT
Patient use of an online portal has been linked to significant improvements in preventive health behaviors, according to a study of 10,000 patients by Penn Medicine researchers.
Results of their retrospective observational cohort, published in the Journal of Medical Internet Research, show that those who used an online patient portal were 50 percent more likely to get a flu shot and twice as likely to have their blood pressure checked, compared with patients who do not use portals.
In addition, patients using the portal were 50 percent more likely to have their cholesterol levels checked.
In the study, patients used a Penn Medicine–branded version of Epic’s MyChart portal—called myPennMedicine—that gives users real-time information about medical records and test results, prescriptions, appointments as well as other important health information.
“This study is among the first to demonstrate that patient portal use is positively associated with patient preventive health behavior outcomes but not with chronic health outcomes,” conclude the study’s authors. “These findings contribute to the understanding and quantification of the impact of patient portal use on patient health outcomes. Additional research is required to confirm these findings.”
More here:
Here is the abstract:
Difference Between Users and Nonusers of a Patient Portal in Health Behaviors and Outcomes: Retrospective Cohort Study
ABSTRACT
Background: Patient portals are frequently used in modern health care systems as an engagement and communication tool. An increased focus on the potential value of these communication channels to improve health outcomes is warranted.
Objective: This paper aimed to quantify the impact of portal use on patients’ preventive health behavior and chronic health outcomes.
Methods: We conducted a retrospective, observational cohort study of 10,000 patients aged 50 years or older who were treated at the University of Pennsylvania Health System (UPHS) from September 1, 2014, to October 31, 2016. The data were sourced from the UPHS electronic health records. We investigated the association between patient portal use and patients’ preventive health behaviors or chronic health outcomes, controlling for confounders using a novel cardinality matching approach based on propensity scoring and a subsequent bootstrapping method to estimate the variance of association estimates.
Results: Patient-level characteristics differed substantially between portal users, comprising approximately 59.32% (5932/10000) of the cohort, and nonusers. On average, users were more likely to be younger (63.46 years for users vs 66.08 years for nonusers), white (72.77% [4317/5932] for users vs 52.58% [2139/4068] for nonusers), have commercial insurance (60.99% [3618/5932] for users vs 40.12% [1632/4068] for nonusers), and have higher annual incomes (US $74,172/year for users vs US $62,940/year for nonusers). Even after adjusting for these potential confounders, patient portal use had a positive and clinically meaningful impact on patients’ preventive health behaviors but not on chronic health outcomes.
Conclusions: This paper contributes to the understanding of the impact of patient portal use on health outcomes and is the first study to identify a meaningful subgroup of patients’ health behaviors that improved with portal use. These findings may encourage providers to promote portal use to improve patients’ preventive health behaviors.
J Med Internet Res 2019;21(10):e13146
doi:10.2196/13146
Here is the link:
The key to understanding what is going on is here with the description of the portal
myPennMedicine
myPennMedicine is a Penn Medicine–branded version of Epic’s MyChart patient-facing electronic medical record. It is a patient portal that provides users with real-time information about medical records and test results, prescriptions, and appointments and other important health information. Patients may use the site to schedule appointments and laboratory tests, communicate with care teams, request prescription renewals and referrals, pay bills, and share records with other health care providers. It is available as a desktop Web portal and as an app for download from the Apple Store and Google Play. Patients must register, create an account, and log in to use these features. A screenshot of the myPennMedicine Web portal is shown in . We defined patient portal users as patients who had registered for myPennMedicine. By May 2019, myPennMedicine had 591,784 unique and alive users. Among them, more than 66% had at least one activity in the past 365 days and approximately 45% and 28% had at least one activity in the past 90 and 30 days, respectively.
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The single point is that this portal provides what people want and will use and all the #myHealthRecord is, is a static non-functional secondary and probably incomplete copy of what your doctor and hospital already have.
Provide what Penn Medicine does and you might find a few people actually use it! I wonder will those responding to the re-platforming RFI make a few suggestions in this direction?
"A major challenge in evaluating the impact of the portal use on patient health outcomes using electronic health record (EHR) data is the inherent selection bias. Specifically, the use of patient portals can be related to patients’ or health care providers’ characteristics, which may confound the associations between the portal use and patient health outcomes. Naïve regression analysis of the health outcomes on patient portal use is biased upward if patients adopted the portal because they have higher health motivations and better strategies of managing health conditions."
ReplyDeleteThe paper does not address the potential of selection bias.
All they found was that patents who are more interested in their health outcomes used the portal more than those who aren't.
The paper actually says "We found that patients’ preventive health behaviors were significantly associated with portal use" Correlation does not imply causation.
What they did not find was that availability of the portal made patients more interested in their health outcomes.
The other observation is that the portal is an access mechanism into a clinical system - something myhr is not and cannot ever be.
which means that the claims from ADHA that giving patients access to their health information will allow them to take control of their health is a load of codswallop.
ReplyDeleteThose who are interested in their health do not need My Health Record. Those who aren't won't give a stuff about it.
$2 billion down the drain, all because of some bureaucratic simpletons in DOH.
The only thing driving My Health Record and the ADHA is the sunk cost fallacy and political pride.