Yearb Med Inform 2015; 24(01): 148-159
DOI: 10.15265/IY-2015-007
Original Article
Georg Thieme Verlag KG Stuttgart

Patient Portals as a Means of Information and Communication Technology Support to Patient-Centric Care Coordination – the Missing Evidence and the Challenges of Evaluation

A joint contribution of IMIA WG EVAL and EFMI WG EVAL
Michael Rigby
1   Keele University, School of Public Policy and Professional Practice, Keele, United Kingdom
,
Andrew Georgiou
2   Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
,
Hannele Hyppönen
3   National Institute for Health and Welfare, Information Department, Helsinki, Finland
,
Elske Ammenwerth
4   UMIT, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
,
Nicolette de Keizer
5   Academic Medical Center, Department of Medical Informatics, Amsterdam, The Netherlands
,
Farah Magrabi
2   Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
,
Philip Scott
6   School of Computing, University of Portsmouth, Portsmouth, United Kingdom
› Institutsangaben
Weitere Informationen

Correspondence to:

Emeritus Professor Michael Rigby
Lavender Hill, 6
Carrighill Lower Calverstown, Kilcullen
Co. Kildare, Ireland
Telefon: +353 45 485858   

Publikationsverlauf

30. Juni 2015

Publikationsdatum:
10. März 2018 (online)

 

Summary

Objectives: To review the potential contribution of Information and Communication Technology (ICT) to enable patient-centric and coordinated care, and in particular to explore the role of patient portals as a developing ICT tool, to assess the available evidence, and to describe the evaluation challenges.

Methods: Reviews of IMIA, EFMI, and other initiatives, together with literature reviews.

Results: We present the progression from care coordination to care integration, and from patient-centric to person-centric approaches. We describe the different roles of ICT as an enabler of the effective presentation of information as and when needed. We focus on the patient‘s role as a co-producer of health as well as the focus and purpose of care. We discuss the need for changing organisational processes as well as the current mixed evidence regarding patient portals as a logical tool, and the reasons for this dichotomy, together with the evaluation principles supported by theoretical frameworks so as to yield robust evidence.

Conclusions: There is expressed commitment to coordinated care and to putting the patient in the centre. However to achieve this, new interactive patient portals will be needed to enable peer communication by all stakeholders including patients and professionals. Few portals capable of this exist to date. The evaluation of these portals as enablers of system change, rather than as simple windows into electronic records, is at an early stage and novel evaluation approaches are needed.


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Correspondence to:

Emeritus Professor Michael Rigby
Lavender Hill, 6
Carrighill Lower Calverstown, Kilcullen
Co. Kildare, Ireland
Telefon: +353 45 485858   

  • References

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  • 4 Kodner DL, Spreeuwenberg C. Integrated care: meaning, logic, applications, and implications-a discussion paper. Int J Integr Care 2002; 2: e12. Available from: URN:NBN:NL:UI:10-1-100309 (accessed 9 December 2014).
  • 5 Goodwin N. Understanding Integrated Care: a complex process, a fundamental principle. Int J Integr Care 2013; 13: e011. Available from: URN:NBN:NL:UI:10-1-114416.
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  • 21 Nettleton S, Hanlon G. ‘Pathways to the Doctor’ in the Information Age: the Role of ICTs. In: Webster A. Contemporary Lay Referral Systems. New Technologies in Health Care Challenge, Change and Innovation. Hampshire: Palgrave Macmillan; 2006. p. 57-70.
  • 22 Department of Health.. The expert patient: a new approach to chronic disease management in the 21st century. London: Stationery Office; 2001
  • 23 http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/expert-patients-programme.aspx (accessed 19 December 2014).
  • 24 http://www.selfmanagementuk.org/services/programmes (accessed 19 December 2014)
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  • 26 Murphy DR, Singh H, Berlin L. Communication breakdowns and diagnostic errors: a radiology perspective. Diagnosis 2014; 1 (04) 253-61.
  • 27 Arnold CW, McNamara M, El-Saden S, Chen S, Taira RK, Bui AAT. Imaging informatics for consumer health: towards a radiology patient portal. J Am Med Inform Assoc 2013; 20 (06) 1028-36.
  • 28 Stevenson FA, Cox K, Britten N, Dundar Y. A systematic review of the research on communication between patients and health care professionals about medicines: the consequences for concordance. Health Expect 2014; 7 (03) 235-45.
  • 29 Alston C, Berger ZD, Brownlee S, Elwyn G, Fowler Jr. FJ, Hall LK. et al. Shared Decision Making Strategies for Best Care: Patient Decision Aids. 2014
  • 30 Blobel B. Onconet: a secure infrastructure to improve cancer patients’ care. Eur J Med Res 2000; Aug 18 5 (08) 360-8.
  • 31 Baldry M, Cheal C, Fisher B, Gillett M, Huet V. Giving patients their own records in general practice: experience of patients and staff. Br Med J 1986; Mar 1 292 6520 596-8.
  • 32 Honeyman A, Cox B, Fisher B. Potential impacts of patient access to their electronic care records. Inform Prim Care 2005; 13 (01) 55-60.
  • 33 Fisher B, Fitton R, Poirier C, Stables D. Patient record access--the time has come. Stud Health Technol Inform 2006; 121: 162-7.
  • 34 Fisher B, Fitton R, Poirier C, Stables D. Patient record access--the time has come!. Br J Gen Pract 2007; Jun; 57 (539) 507-11.
  • 35 http://www.paers.net/index.shtml (accessed 19 December 2014)
  • 36 Ammenwerth E, Schnell-Inderst P, Hoerbst A. The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials. J Med Internet Res 2012; 14 (06) e162. doi:10.2196/ jmir.2238].
  • 37 Bourgeois FC, Mandl KD, Shaw D, Flemming D, Nigrin DJ. Mychildren’s: integration of a personally controlled health record with a tethered patient portal for a pediatric and adolescent population. AMIA Annu Symp Proc 2009; 2009: 65-69.
  • 38 Institute of Medicine.. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington: National Academy Press; 2001
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