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The wired patient: patterns of electronic patient portal use among patients with cardiac disease or diabetes.

Jones JB, Weiner JP, Shah NR, Stewart WF - J. Med. Internet Res. (2015)

Bottom Line: Other distinct groups were characterized by tracking biometric measures (10.54%, 238/2258), sending electronic messages to their provider (9.25%, 209/2258), preparing for an office visit (5.98%, 135/2258), and tracking laboratory results (4.16%, 94/2258).More than half of the patient cohort exhibited distinct patterns of portal use linked to key features.These patterns of portal access and interaction provide insight into opportunities for electronic patient engagement strategies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Research, Development and Dissemination, Sutter Health, Walnut Creek, CA, United States. jonesjb@sutterhealth.org.

ABSTRACT

Background: As providers develop an electronic health record-based infrastructure, patients are increasingly using Web portals to access their health information and participate electronically in the health care process. Little is known about how such portals are actually used.

Objective: In this paper, our goal was to describe the types and patterns of portal users in an integrated delivery system.

Methods: We analyzed 12 months of data from Web server log files on 2282 patients using a Web-based portal to their electronic health record (EHR). We obtained data for patients with cardiovascular disease and/or diabetes who had a Geisinger Clinic primary care provider and were registered "MyGeisinger" Web portal users. Hierarchical cluster analysis was applied to longitudinal data to profile users based on their frequency, intensity, and consistency of use. User types were characterized by basic demographic data from the EHR.

Results: We identified eight distinct portal user groups. The two largest groups (41.98%, 948/2258 and 24.84%, 561/2258) logged into the portal infrequently but had markedly different levels of engagement with their medical record. Other distinct groups were characterized by tracking biometric measures (10.54%, 238/2258), sending electronic messages to their provider (9.25%, 209/2258), preparing for an office visit (5.98%, 135/2258), and tracking laboratory results (4.16%, 94/2258).

Conclusions: There are naturally occurring groups of EHR Web portal users within a population of adult primary care patients with chronic conditions. More than half of the patient cohort exhibited distinct patterns of portal use linked to key features. These patterns of portal access and interaction provide insight into opportunities for electronic patient engagement strategies.

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Related in: MedlinePlus

Summary of the process for parsing the log file using Perl. MRN: medical record number.
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figure2: Summary of the process for parsing the log file using Perl. MRN: medical record number.

Mentions: For each session, variables were created to quantify the length of the session (with adjustments made to account for time-outs) and to count the number of times each function (eg, checking lab results, emailing a physician) was used over the course of the study period. In this context, “use” of a function meant that a patient clicked on a link on the main MyGeisinger menu (eg, “Lab Results”) or a link available from within a specific menu option (eg, a link to review a specific lab result). Patients were able to access each function multiple times during a session. For each patient, we counted each time a link was clicked and summed these at the session level for each function. In addition, we created variables to describe the frequency, consistency, intensity, and duration of portal use. Portal transactions were classified as administrative (ie, appointment-related functions, driving directions to a Geisinger Clinic, provider details, proxy functions, and referral functions) or otherwise categorized as clinical. We counted the total number of administrative and clinical transactions across all sessions in the study period and calculated the administrative-to-care ratio (a ratio >1.0 indicates that participants used more administrative functions). The log file was processed using a custom-programmed script (available on request) written in the Perl programming language. A schematic overview of the way the Perl script processed the log file is shown in Figure 2.


The wired patient: patterns of electronic patient portal use among patients with cardiac disease or diabetes.

Jones JB, Weiner JP, Shah NR, Stewart WF - J. Med. Internet Res. (2015)

Summary of the process for parsing the log file using Perl. MRN: medical record number.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4376207&req=5

figure2: Summary of the process for parsing the log file using Perl. MRN: medical record number.
Mentions: For each session, variables were created to quantify the length of the session (with adjustments made to account for time-outs) and to count the number of times each function (eg, checking lab results, emailing a physician) was used over the course of the study period. In this context, “use” of a function meant that a patient clicked on a link on the main MyGeisinger menu (eg, “Lab Results”) or a link available from within a specific menu option (eg, a link to review a specific lab result). Patients were able to access each function multiple times during a session. For each patient, we counted each time a link was clicked and summed these at the session level for each function. In addition, we created variables to describe the frequency, consistency, intensity, and duration of portal use. Portal transactions were classified as administrative (ie, appointment-related functions, driving directions to a Geisinger Clinic, provider details, proxy functions, and referral functions) or otherwise categorized as clinical. We counted the total number of administrative and clinical transactions across all sessions in the study period and calculated the administrative-to-care ratio (a ratio >1.0 indicates that participants used more administrative functions). The log file was processed using a custom-programmed script (available on request) written in the Perl programming language. A schematic overview of the way the Perl script processed the log file is shown in Figure 2.

Bottom Line: Other distinct groups were characterized by tracking biometric measures (10.54%, 238/2258), sending electronic messages to their provider (9.25%, 209/2258), preparing for an office visit (5.98%, 135/2258), and tracking laboratory results (4.16%, 94/2258).More than half of the patient cohort exhibited distinct patterns of portal use linked to key features.These patterns of portal access and interaction provide insight into opportunities for electronic patient engagement strategies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Research, Development and Dissemination, Sutter Health, Walnut Creek, CA, United States. jonesjb@sutterhealth.org.

ABSTRACT

Background: As providers develop an electronic health record-based infrastructure, patients are increasingly using Web portals to access their health information and participate electronically in the health care process. Little is known about how such portals are actually used.

Objective: In this paper, our goal was to describe the types and patterns of portal users in an integrated delivery system.

Methods: We analyzed 12 months of data from Web server log files on 2282 patients using a Web-based portal to their electronic health record (EHR). We obtained data for patients with cardiovascular disease and/or diabetes who had a Geisinger Clinic primary care provider and were registered "MyGeisinger" Web portal users. Hierarchical cluster analysis was applied to longitudinal data to profile users based on their frequency, intensity, and consistency of use. User types were characterized by basic demographic data from the EHR.

Results: We identified eight distinct portal user groups. The two largest groups (41.98%, 948/2258 and 24.84%, 561/2258) logged into the portal infrequently but had markedly different levels of engagement with their medical record. Other distinct groups were characterized by tracking biometric measures (10.54%, 238/2258), sending electronic messages to their provider (9.25%, 209/2258), preparing for an office visit (5.98%, 135/2258), and tracking laboratory results (4.16%, 94/2258).

Conclusions: There are naturally occurring groups of EHR Web portal users within a population of adult primary care patients with chronic conditions. More than half of the patient cohort exhibited distinct patterns of portal use linked to key features. These patterns of portal access and interaction provide insight into opportunities for electronic patient engagement strategies.

Show MeSH
Related in: MedlinePlus