Jennifer Dickman Portz1,2, John David Powers2, Alejandra Casillas3, Megan Baldwin2, David B Bekelman1,4, Ted E Palen2, Sheana Bull5, Jean S Kutner1, Elizabeth Bayliss2. 1. Division of General Internal Medicine, University of Colorado Anschutz Medical, Aurora, Colorado, USA. 2. Insitute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA. 3. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, California, USA. 4. Department of Medicine, Department of Veterans Affairs, Eastern Colorado Health Care System, Aurora, Colorado, USA. 5. mHealth Impact Lab, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA.
Abstract
Background: There are few studies examining the usage and utility of patient portals among seriously ill and end-of-life populations and their caregivers. Objective: The aim of this study was to describe portal user characteristics among patients and their caregivers (proxy login) at two time points: (1) the 12 months following an electronic medical record flag for serious illness and (2) during the last 12 months of life. Methods: A retrospective cohort analysis of Kaiser Permanente Colorado (KPCO) patients with serious illness, as defined by Kaiser Permanente's prognostic algorithm, and their proxy caregivers was performed for the two time periods. Use was characterized as (1) the discrete number of days the portal was used and (2) the number of days that portal features were accessed. Differences in use by user characteristics were assessed. Results: Patients flagged for serious illness (N = 6129) were 70.4 ± 14.2 years of age, and used the portal on average 50.4 days. Patients (N = 6517) in the last year of life were 76.7 ± 13.7 years of age and used the portal on average 43 days. Caregiver proxy use of the portal was low in both cohorts. Patients who were older, female, non-White, and healthier were less likely to use the portal. Conclusions: In comparison with overall KPCO portal use and recent patient portal studies examining use patterns, patient portal use was high among patients flagged with serious illness and nearing the end of life. However, because use was associated with age, gender, and race, addressing barriers to portal adoption among underserved populations and caregiver proxies is key to better leveraging patient portal systems for palliative and end-of-life care.
Background: There are few studies examining the usage and utility of patient portals among seriously ill and end-of-life populations and their caregivers. Objective: The aim of this study was to describe portal user characteristics among patients and their caregivers (proxy login) at two time points: (1) the 12 months following an electronic medical record flag for serious illness and (2) during the last 12 months of life. Methods: A retrospective cohort analysis of Kaiser Permanente Colorado (KPCO) patients with serious illness, as defined by Kaiser Permanente's prognostic algorithm, and their proxy caregivers was performed for the two time periods. Use was characterized as (1) the discrete number of days the portal was used and (2) the number of days that portal features were accessed. Differences in use by user characteristics were assessed. Results: Patients flagged for serious illness (N = 6129) were 70.4 ± 14.2 years of age, and used the portal on average 50.4 days. Patients (N = 6517) in the last year of life were 76.7 ± 13.7 years of age and used the portal on average 43 days. Caregiver proxy use of the portal was low in both cohorts. Patients who were older, female, non-White, and healthier were less likely to use the portal. Conclusions: In comparison with overall KPCO portal use and recent patient portal studies examining use patterns, patient portal use was high among patients flagged with serious illness and nearing the end of life. However, because use was associated with age, gender, and race, addressing barriers to portal adoption among underserved populations and caregiver proxies is key to better leveraging patient portal systems for palliative and end-of-life care.
Entities:
Keywords:
digital health; electronic medical record; patient portal utilization; personal health record
Authors: Sarah R Jordan; Adreanne Brungardt; Phoutdavone Phimphasone-Brady; Hillary D Lum Journal: Am J Hosp Palliat Care Date: 2019-02-25 Impact factor: 2.500
Authors: Thomas A Arcury; Sara A Quandt; Joanne C Sandberg; David P Miller; Celine Latulipe; Xiaoyan Leng; Jenifer W Talton; Kathryn P Melius; Alden Smith; Alain G Bertoni Journal: JMIR Med Inform Date: 2017-11-14
Authors: Jennifer Dickman Portz; Elizabeth A Bayliss; Sheana Bull; Rebecca S Boxer; David B Bekelman; Kathy Gleason; Sara Czaja Journal: J Med Internet Res Date: 2019-04-08 Impact factor: 5.428
Authors: Celine Latulipe; Sara A Quandt; Kathryn Altizer Melius; Alain Bertoni; David P Miller; Douglas Smith; Thomas A Arcury Journal: J Med Internet Res Date: 2018-11-02 Impact factor: 5.428