High Tech and High Touch (HT2): Transforming Patient Engagement Through Portal Technology at the Bedside
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,782
- 试验地点
- 2
- 主要终点
- Patient Satisfaction With Care - Interactions With Healthcare Professionals
研究概览
简要总结
A large-scale randomized control trial (RCT) of the impact and use of an inpatient tablet-based patient portal embedded in a larger mixed methods study to examine changes in patient experiences and outcomes, and subsequent ambulatory patient portal usage.
详细描述
The appropriate use of technology to actively engage with patients who suffer from multiple chronic conditions, called multimorbidity, is one of the frontiers of both research and practice. For multimorbid patients, engagement in disease management activities is particularly critical, and evidence shows that enhanced patient self-management can lead to better control of chronic illness. One tool finding increasing use is the patient portal, and its pervasiveness is supported by virtue of its role as a component of the Meaningful Use criteria. A patient portal is a tethered personal health record (tPHR) that links to the patient's electronic health record, facilitating communication and engagement activities with healthcare providers. While most tPHRs have been focused on outpatient activities, a new class of tools focused on the inpatient experience has begun deployment in 2014.
In response, this study supports the conduct of the first, large-scale randomized control trial (RCT) of the impact and use of an inpatient tablet-based patient portal embedded in a larger mixed methods study to examine changes in patient experiences and outcomes, and subsequent ambulatory patient portal usage. The investigators aim to study how access to a patient portal tailored to the inpatient stay can improve patient experience and increase patient engagement by improving patients' perception of the process of care while in the hospital (patient experience), increasing patients' self-efficacy for managing their chronic conditions (patient engagement), and facilitating use of a patient portal for care management activities after discharge (patient engagement).
The study site is a world-class healthcare facility with the ability to provide access to a patient portal designed specifically for the inpatient experience, bridging to outside the hospital after discharge.
Currently, this inpatient technology exists in only one other hospital in the US, but the investigators expect that as inpatient PHRs become more readily available, the need for clarity on this issue will only increase. The investigator's evaluation is a mixed-methods design consisting of primary data collection through surveys and interviews throughout the study period, and secondary data collection from the electronic health record and health system metadata. This study will offer insight into a potentially important mechanism to facilitate patient self-management.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Health Services Research
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
Patient Satisfaction With Care - Interactions With Healthcare Professionals
时间窗: 6 months after discharge
Questions from the satisfaction and experience domains of the 6-month Post-discharge surveys were used to assess patient satisfaction with their care. Answers to the following 5-point Likert scale survey item were explored: "In your most recent hospital experience, how satisfied were you with the interactions you had with your healthcare professionals? ". Responses were dichotomized to one "most positive" response versus all other responses.
Patient Involvement With Care - Questions About Health Management
时间窗: 15 days after discharge.
Questions from the involvement with care domain of the 15-day Post-discharge surveys were used to assess patient involvement with their care. Answers to the following 5-point Likert scale survey item were explored: "All of my questions about managing my health, including my medications, were addressed before I left the hospital.". Responses were dichotomized to one "most positive" response versus all other responses.
Patient Involvement With Care - Finding Answers to Health Management Questions
时间窗: 15 days after discharge.
Questions from the involvement with care domain of the 15-day Post-discharge surveys were used to assess patient involvement with their care. Answers to the following multiple-choice survey item were explored: "If you had a question about your care while you were in the hospital, what steps did you take to find an answer? (mark all that apply)".
Inpatient Portal Use Frequency
时间窗: At hospital discharge.
The count of MyChart Bedside (inpatient portal) sessions for the admission associated with study enrollment.
Inpatient Portal Comprehensiveness of Use
时间窗: At hospital discharge.
Based on the use of all available MyChart Bedside (inpatient portal) functions, a comprehensive inpatient portal user was one who used all three functions - for patients in the low tech assignment - or used eight or more functions - for patients in the high tech assignment.
Patient Involvement With Care - Tablet's Activities
时间窗: 15 days after discharge.
Questions from the involvement with care domain of the 15-day Post-discharge surveys were used to assess patient involvement with their care. Answers to the following multiple-choice survey item were explored: "What kind of activities did you use the table for? (mark all that apply)".
Inpatient Portal Functions Proportion of Use
时间窗: At hospital discharge.
For each MyChart Bedside (inpatient portal) function available to patients assigned to high tech, a proportion of total use is calculated for each patient as the sum of actions in a given function divided for the total sum of user actions during the hospital admission associated with study enrollment.
Patient Satisfaction With Care - Responses From Healthcare Professionals
时间窗: 6 months after discharge
Questions from the satisfaction and experience domains of the 6-month Post-discharge surveys were used to assess patient satisfaction with their care. Answers to the following 5-point Likert scale survey item were explored: "In the past 6 months, how satisfied were you with how well your healthcare professionals responded to your concerns? ". Responses were dichotomized to one "most positive" response versus all other responses.
次要结局
- Self-Efficacy(6 months post-discharge)
- Outpatient Portal Adoption(3 months post-discharge)
- Outpatient Portal Frequency of Use(3 months post-discharge)
研究者
Ann McAlearney
Professor of Family Medicine and Executive Director, CATALYST
Ohio State University