Dataset Information

Factors Affecting the Extent of Patients' Electronic Medical Record Use: An Empirical Study Focusing on System and Patient Characteristics.

ABSTRACT:

Background

Patients' access to and use of electronic medical records (EMRs) places greater information in their hands, which helps them better comanage their health, leading to better clinical outcomes. Despite numerous benefits that promote health and well-being, patients' acceptance and use of EMRs remains low. We study the impact of predictors that affect the use of EMR by patients to understand better the underlying causal factors for the lower use of EMR.

Objective

This study aims to examine the critical system (eg, performance expectancy and effort expectancy) and patient characteristics (eg, health condition, issue involvement, preventive health behaviors, and caregiving status) that influence the extent of patients' EMR use.

Methods

We used secondary data collected by Health Information National Trends Survey 5 cycle 3 and performed survey data analysis using structural equation modeling technique to test our hypotheses. Structural equation modeling is a technique commonly used to measure and analyze the relationships of observed and latent variables. We also addressed common method bias to understand if there was any systematic effect on the observed correlation between the measures for the predictor and predicted variables.

Results

The statistically significant drivers of the extent of EMR use were performance expectancy (β=.253; P<.001), perceived behavior control (β=.236; P<.001), health knowledge (β=-.071; P=.007), caregiving status (β=.059; P=.013), issue involvement (β=.356; P<.001), chronic conditions (β=.071; P=.016), and preventive health behavior (β=.076; P=.005). The model accounted for 32.9% of the variance in the extent of EMR use.

Conclusions

The study found that health characteristics, such as chronic conditions and patient disposition (eg, preventive health behavior and issue involvement), directly affect the extent of EMR use. The study also revealed that issue involvement mediates the impact of preventive health behaviors and the presence of chronic conditions on the extent of patients' EMR use.

SUBMITTER: Agrawal L

PROVIDER: S-EPMC8587186 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

Factors Affecting the Extent of Patients' Electronic Medical Record Use: An Empirical Study Focusing on System and Patient Characteristics.

Agrawal Lavlin L Ndabu Theophile T Mulgund Pavankumar P Sharman Raj R

Journal of medical Internet research 20211028 10

<h4>Background</h4>Patients' access to and use of electronic medical records (EMRs) places greater information in their hands, which helps them better comanage their health, leading to better clinical outcomes. Despite numerous benefits that promote health and well-being, patients' acceptance and use of EMRs remains low. We study the impact of predictors that affect the use of EMR by patients to understand better the underlying causal factors for the lower use of EMR.<h4>Objective</h4>This study ...[more]

PMID: 34709181

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Project description:ImportanceWhile dosing reminders for glaucoma medications have been shown to increase drug adherence, an outstanding limitation preventing broad adoption is difficulty linking reminders to medication in each patient's electronic health record (EHR).ObjectiveTo examine the feasibility of implementing an EHR-linked, automated reminder system for glaucoma medications and assess patient satisfaction with it.Design, setting, and participantsIn this prospective, cross-sectional study, patients receiving glaucoma medications were recruited from a university-based glaucoma clinic from April 2017 to January 2018. Analysis began in February 2018.ExposuresA web-based application was added to the EHR patient portal, allowing patients to configure telecommunication-based reminders for their glaucoma medications. For all potential participants, basic information was collected to determine risk of nonadherence with glaucoma medications. Those consenting to participate then answered questions on medication adherence, reminders, and their likelihood of using EHR-linked reminders. They then configured reminders using the EHR patient portal. After 3 months, they answered questions about their satisfaction with the system.Main outcomes and measuresProportions of patients and high-risk patients willing to use the reminders, and patient satisfaction with the system.ResultsOf 147 patients approached, 100 (68%) agreed to participate, of whom the majority were men (54 [54%]) and white (51 [51%]), with a mean (SD) age of 65 (12.4) years. There were no differences between those willing and unwilling to participate, except for a slightly lower self-reported medication adherence rate among those who participated (mean [SD], 91% [13.6%] vs 97% [6.0%]). Based on a previously validated risk assessment score, 9% (9 of 100) of participants were categorized as being at high risk for poor adherence (≥50% probability of nonadherence) compared with 11% (5 of 47) of nonparticipants. Of 100 participants, 94 ultimately configured reminders, of whom 89 (95%) completed follow-up. On follow-up, 74% (n = 66; 95% CI, 65-83) of participants found the reminders to be useful, 15% (n = 13) were neutral, and 11% (n = 10) found them not useful. Most participants (72 [81%]; 95% CI, 77-85) had help configuring reminders.Conclusions and relevanceElectronic health records-linked reminders had good uptake and were well received among patients at a tertiary glaucoma clinic. These portals may represent a new and convenient method of allowing patients to link their glaucoma medications to automated reminders, although the generalizability of these results and the effect on glaucoma outcomes remains unknown.

Project description:Background/aimCost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content.MethodsThe Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health-sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content.ResultsOf the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005).ConclusionPatient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.

Dataset Information

Factors Affecting the Extent of Patients' Electronic Medical Record Use: An Empirical Study Focusing on System and Patient Characteristics.

Background

Objective

Methods

Results

Conclusions

Publications

Factors Affecting the Extent of Patients' Electronic Medical Record Use: An Empirical Study Focusing on System and Patient Characteristics.

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