J. Med. Internet Res. - Patients' continuing use of an online health record: a quantitative evaluation of 14,000 patient years of access data.

Tópicos

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Resumo

CKGROUND: Online access to all or part of their health records is widely demanded by patients and, where provided in form of patient portals, has been substantially used by at least subgroups of patients, particularly those with chronic disease. However, little is reported regarding the longer-term patient use of patient-accessible electronic health record services, which is important in allocating resources. Renal PatientView (RPV) is an established system that gives patients with chronic kidney disease access to live test results and information about their condition and treatment. It is available in most UK renal units with up to 75% of particular patient groups registered in some centers. We have analyzed patient use out to 4 years and investigated factors associated with more persistent use.OBJECTIVE: Our aim was to investigate RPV use by patients over time from initial registration in order to understand which patients choose to access RPV and the endurance of its appeal for different patient groups.METHODS: We analyzed an anonymized extract of the database underlying RPV containing information on patient registration and events including patient access and the arrival of new blood test results or letters that patients might wish to view.RESULTS: At the time of the extract, there were 11,352 patients registered on RPV for 0-42 months (median 17). More than half of registrants became persistent users, logging in a median of 2.0 times each month over post-registration intervals of up to 42 months (median 18.9). Provision of assistance with first logon was strongly associated with becoming a persistent user, even at 3 years. Logons by persistent users occurred around the time of consultations/tests, strongly suggestive of patient engagement. While indices indicative of greater deprivation were the strongest determinants of non-participation, they had negligible influence on drop-out rates among established users.CONCLUSIONS: In this mature patient portal system, a large proportion of patients made regular use of their online health records over protracted periods. The patterns and timing of use indicate strong patient interest in detailed information such as recent test results and clinic letters. Supporting patients through the first steps of establishing access to their online records is associated with much higher rates of long-term use of RPV and likely would increase use of other electronic health records provided for patients with chronic disease.

Resumo Limpo

ckground onlin access part health record wide demand patient provid form patient portal substanti use least subgroup patient particular chronic diseas howev littl report regard longerterm patient use patientaccess electron health record servic import alloc resourc renal patientview rpv establish system give patient chronic kidney diseas access live test result inform condit treatment avail uk renal unit particular patient group regist center analyz patient use year investig factor associ persist useobject aim investig rpv use patient time initi registr order understand patient choos access rpv endur appeal differ patient groupsmethod analyz anonym extract databas under rpv contain inform patient registr event includ patient access arriv new blood test result letter patient might wish viewresult time extract patient regist rpv month median half registr becam persist user log median time month postregistr interv month median provis assist first logon strong associ becom persist user even year logon persist user occur around time consultationstest strong suggest patient engag indic indic greater depriv strongest determin nonparticip neglig influenc dropout rate among establish usersconclus matur patient portal system larg proport patient made regular use onlin health record protract period pattern time use indic strong patient interest detail inform recent test result clinic letter support patient first step establish access onlin record associ much higher rate longterm use rpv like increas use electron health record provid patient chronic diseas

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