Rebecca G Mishuris1,2,3, Max Stewart1, Gemmae M Fix4,5, Thomas Marcello1,2,4, D Keith McInnes4,5,6,7, Timothy P Hogan2,4,8, Judith B Boardman9,10, Steven R Simon1,2,3. 1. Section of General Internal Medicine, VA Boston Healthcare System, Boston, MA, USA. 2. Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA. 3. Harvard Medical School, Boston, MA, USA. 4. Center for Healthcare Organization and Implementation Research (CHOIR), VA Health Services Research and Development Service, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA. 5. Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA. 6. HIV/Hepatitis Quality Enhancement Research Initiative (QUERI) Program, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA. 7. eHealth Quality Enhancement Research Initiative (QUERI), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA. 8. Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA. 9. Home Based Primary Care Program, VA Boston Healthcare System, Boston, MA, USA. 10. Salem State University, Salem, MA, USA.
Abstract
BACKGROUND: Electronic, or web-based, patient portals can improve patient satisfaction, engagement and health outcomes and are becoming more prevalent with the advent of meaningful use incentives. However, adoption rates are low, particularly among vulnerable patient populations, such as those patients who are home-bound with multiple comorbidities. Little is known about how these patients view patient portals or their barriers to using them. OBJECTIVE: To identify barriers to and facilitators of using My HealtheVet (MHV), the United States Department of Veterans Affairs (VA) patient portal, among Veterans using home-based primary care services. DESIGN: Qualitative study using in-depth semi-structured interviews. We conducted a content analysis informed by grounded theory. PARTICIPANTS: Fourteen Veterans receiving home-based primary care, surrogates of two of these Veterans, and three home-based primary care (HBPC) staff members. KEY RESULTS: We identified five themes related to the use of MHV: limited knowledge; satisfaction with current HBPC care; limited computer and Internet access; desire to learn more about MHV and its potential use; and value of surrogates acting as intermediaries between Veterans and MHV. CONCLUSIONS: Despite their limited knowledge of MHV and computer access, home-bound Veterans are interested in accessing MHV and using it as an additional point of care. Surrogates are also potential users of MHV on behalf of these Veterans and may have different barriers to and benefits from use.
BACKGROUND: Electronic, or web-based, patient portals can improve patient satisfaction, engagement and health outcomes and are becoming more prevalent with the advent of meaningful use incentives. However, adoption rates are low, particularly among vulnerable patient populations, such as those patients who are home-bound with multiple comorbidities. Little is known about how these patients view patient portals or their barriers to using them. OBJECTIVE: To identify barriers to and facilitators of using My HealtheVet (MHV), the United States Department of Veterans Affairs (VA) patient portal, among Veterans using home-based primary care services. DESIGN: Qualitative study using in-depth semi-structured interviews. We conducted a content analysis informed by grounded theory. PARTICIPANTS: Fourteen Veterans receiving home-based primary care, surrogates of two of these Veterans, and three home-based primary care (HBPC) staff members. KEY RESULTS: We identified five themes related to the use of MHV: limited knowledge; satisfaction with current HBPC care; limited computer and Internet access; desire to learn more about MHV and its potential use; and value of surrogates acting as intermediaries between Veterans and MHV. CONCLUSIONS: Despite their limited knowledge of MHV and computer access, home-bound Veterans are interested in accessing MHV and using it as an additional point of care. Surrogates are also potential users of MHV on behalf of these Veterans and may have different barriers to and benefits from use.
Authors: Rajani S Sadasivam; Rebecca L Kinney; Stephenie C Lemon; Stephanie L Shimada; Jeroan J Allison; Thomas K Houston Journal: Int J Med Inform Date: 2012-11-11 Impact factor: 4.046
Authors: Sara J Czaja; Joseph Sharit; Chin Chin Lee; Sankaran N Nair; Mario A Hernández; Neysarí Arana; Shih Hua Fu Journal: J Am Med Inform Assoc Date: 2012-07-16 Impact factor: 4.497
Authors: Alex H Cho; Nedal H Arar; David E Edelman; Patricia H Hartwell; Eugene Z Oddone; William S Yancy Journal: Telemed J E Health Date: 2010-06 Impact factor: 3.536
Authors: Donna M Zulman; Kim M Nazi; Carolyn L Turvey; Todd H Wagner; Susan S Woods; Larry C An Journal: Ann Intern Med Date: 2011-12-20 Impact factor: 25.391
Authors: Peggy J Wagner; James Dias; Shalon Howard; Kristina W Kintziger; Matthew F Hudson; Yoon-Ho Seol; Pat Sodomka Journal: J Am Med Inform Assoc Date: 2012-01-10 Impact factor: 4.497
Authors: D Keith McInnes; Jeffrey L Solomon; Stephanie L Shimada; Beth A Petrakis; Barbara G Bokhour; Steven M Asch; Kim M Nazi; Thomas K Houston; Allen L Gifford Journal: Med Care Date: 2013-03 Impact factor: 2.983
Authors: Robert J Reid; Paul A Fishman; Onchee Yu; Tyler R Ross; James T Tufano; Michael P Soman; Eric B Larson Journal: Am J Manag Care Date: 2009-09-01 Impact factor: 2.229
Authors: Jane Y Zhao; Buer Song; Edwin Anand; Diane Schwartz; Mandip Panesar; Gretchen P Jackson; Peter L Elkin Journal: AMIA Annu Symp Proc Date: 2018-04-16
Authors: John N Mafi; Roanne Mejilla; Henry Feldman; Long Ngo; Tom Delbanco; Jonathan Darer; Christina Wee; Jan Walker Journal: J Am Med Inform Assoc Date: 2016-02-11 Impact factor: 4.497
Authors: Lisa V Grossman; Ruth M Masterson Creber; Natalie C Benda; Drew Wright; David K Vawdrey; Jessica S Ancker Journal: J Am Med Inform Assoc Date: 2019-08-01 Impact factor: 4.497
Authors: Sarah S Nouri; Julia Adler-Milstein; Crishyashi Thao; Prasad Acharya; Jill Barr-Walker; Urmimala Sarkar; Courtney Lyles Journal: J Am Med Inform Assoc Date: 2020-05-01 Impact factor: 4.497
Authors: Courtney R Lyles; Eugene C Nelson; Susan Frampton; Patricia C Dykes; Anupama G Cemballi; Urmimala Sarkar Journal: Ann Intern Med Date: 2020-06-02 Impact factor: 25.391
Authors: Lina Tieu; Urmimala Sarkar; Dean Schillinger; James D Ralston; Neda Ratanawongsa; Rena Pasick; Courtney R Lyles Journal: J Med Internet Res Date: 2015-12-03 Impact factor: 5.428
Authors: Samuel G Smith; Rachel O'Conor; William Aitken; Laura M Curtis; Michael S Wolf; Mita Sanghavi Goel Journal: J Am Med Inform Assoc Date: 2015-04-25 Impact factor: 4.497