Top

21-06-2018 | Devices and technology | Article

Diabetes care providers’ opinions and working methods after four years of experience with a diabetes patient web portal; a survey among health care providers in general practices and an outpatient clinic

Journal: BMC Family Practice

Authors: Maaike C. M. Ronda, Lioe-Ting Dijkhorst-Oei, Rimke C. Vos, Guy E. H. M. Rutten

Publisher: BioMed Central

Abstract

Background

To gain insight into the opinions and working methods of diabetes care providers after using a diabetes web portal for 4 years in order to understand the role of the provider in patients’ web portal use.

Methods

Survey among physicians and nurses from general practices and an outpatient clinic, correlated with data from the common web portal.

Results

One hundred twenty-eight questionnaires were analysed (response rate 56.6%). Responders’ mean age was 46.2 ± 9.8 years and 43.8% were physicians. The majority was of opinion that the portal improves patients’ diabetes knowledge (90.6%) and quality of care (72.7%). Although uploading glucose diary (93.6%) and patient access to laboratory and clinical notes (91.2 and 71.0%) were considered important, these features were recommended to patients in only 71.8 and 19.5% respectively. 64.8% declared they informed their patients about the portal and 45.3% handed-out the information leaflet and website address. The portal was especially recommended to type 1 diabetes patients (78.3%); those on insulin (84.3%) and patients aged< 65 years (72.4%). Few found it timesaving (21.9%). Diabetes care providers’ opinions were not associated with patients’ portal use.

Conclusions

Providers are positive about patients web portals but still not recommend or encourage the use to all patients. There seems room for improvement in their working methods.

WHO: Global status report on noncommunicable diseases; 2014.

Andreassen HK, Bujnowska-Fedak MM, Chronaki CE, Dumitru RC, Pudule I, Santana S, Voss H, Wynn R. European citizens’ use of E-health services: a study of seven countries. BMC Public Health. 2007;7:53.CrossRefPubMedPubMedCentral

Osborn CY, Mayberry LS, Mulvaney SA, Hess R. Patient web portals to improve diabetes outcomes: a systematic review. Curr Diab Rep. 2010;10(6):422–35.CrossRefPubMedPubMedCentral

Zhou YYG, Garrido T, Chin HL, Wiesenthal AM, Liang LL. Patient access to an electronic health record with secure messaging: impact on primary care utilization. Am J Manag Care. 2007;13:6.

Ralston JD, Hirsch IB, Hoath J, Mullen M, Cheadle A, Goldberg HI. Web-based collaborative care for type 2 diabetes: a pilot randomized trial. Diabetes Care. 2009;32(2):234–9.CrossRefPubMedPubMedCentral

Holbrook A, Thabane L, Keshavjee K, Dolovich L, Bernstein B, Chan D, Troyan S, Foster G, Gerstein H. Individualized electronic decision support and reminders to improve diabetes care in the community: COMPET5rfcE II randomized trial. CMAJ. 2009;181(1–2):37–44.CrossRefPubMedPubMedCentral

McCarrier KP, Ralston JD, Hirsch IB, Leweis G, Martin DP, Zimmerman FJ, Goldberg HI. Web-based collaborative care for type 1 diabetes: a pilot randomized trial. Diabetes Technol Ther. 2009;11(4):211–7.CrossRefPubMedPubMedCentral

Wald JS, Businger A, Gandhi TK, Grant RW, Poon EG, Schnipper JL, Volk LA, Middleton B. Implementing practice-linked pre-visit electronic journals in primary care: patient and physician use and satisfaction. J Am Med Inform Assoc. 2010;17(5):502–6.CrossRefPubMedPubMedCentral

Greenhalgh T, Hinder S, Stramer K, Bratan T, Russell J. Adoption, non-adoption, and abandonment of a personal electronic health record: case study of HealthSpace. BMJ. 2010;341:c5814.CrossRefPubMedPubMedCentral

10.

Weppner WG, Ralston JD, Koepsell TD, Grothaus LC, Reid RJ, Jordan L, Larson EB. Use of a shared medical record with secure messaging by older patients with diabetes. Diabetes Care. 2010;33(11):2314–9.CrossRefPubMedPubMedCentral

11.

Sarkar U, Karter AJ, Liu JY, Adler NE, Nguyen R, Lopez A, Schillinger D. Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access. J Am Med Inform Assoc. 2011;18(3):318–21.CrossRefPubMedPubMedCentral

12.

Yamin CK, Emani S, Williams DH, Lipsitz SR, Karson AS, Wald JS, Bates DW. The digital divide in adoption and use of a personal health record. Arch Intern Med. 2011;171(6):568–74.CrossRefPubMed

13.

Black H, Gonzalez R, Priolo C, Schapira MM, Sonnad SS, Hanson CW 3rd, Langlotz CP, Howell JT, Apter AJ. True “meaningful use”: technology meets both patient and provider needs. Am J Manag Care. 2015;21(5):e329–37.PubMed

14.

Ronda MC, Dijkhorst-Oei LT, Rutten GE. Reasons and barriers for using a patient portal: survey among patients with diabetes mellitus. J Med Internet Res. 2014;16(11):e263.CrossRefPubMedPubMedCentral

15.

Fuji KT, Galt KA, Serocca AB. Personal health record use by patients as perceived by ambulatory care physicians in Nebraska and South Dakota: a cross-sectional study. Perspect Health Inf Manag. 2008;5:15.PubMedPubMedCentral

16.

Witry MJ, Doucette WR, Daly JM, Levy BT, Chrischilles EA. Family physician perceptions of personal health records. Perspect Health Inf Manag. 2010;7:1d.PubMedPubMedCentral

17.

Hassol A, Walker JM, Kidder D, Rokita K, Young D, Pierdon S, Deitz D, Kuck S, Ortiz E. Patient experiences and attitudes about access to a patient electronic health care record and linked web messaging. J Am Med Inform Assoc. 2004;11(6):505–13.CrossRefPubMedPubMedCentral

18.

Zickmund SL, Hess R, Bryce CL, McTigue K, Olshansky E, Fitzgerald K, Fischer GS. Interest in the use of computerized patient portals: role of the provider-patient relationship. J Gen Intern Med. 2008;23(Suppl 1):20–6.CrossRefPubMed

19.

Walker J, Leveille SG, Ngo L, Vodicka E, Darer JD, Dhanireddy S, Elmore JG, Feldman HJ, Lichtenfeld MJ, Oster N, et al. Inviting patients to read their doctors’ notes: patients and doctors look ahead: patient and physician surveys. Ann Intern Med. 2011;155(12):811–9.CrossRefPubMedPubMedCentral

20.

Crotty BH, Mostaghimi A, Landon BE. Preparing residents for future practice: report of a curriculum for electronic patient-doctor communication. Postgrad Med J. 2013;89(1056):554–9.CrossRefPubMed

21.

Delbanco T, Walker J, Bell SK, Darer JD, Elmore JG, Farag N, Feldman HJ, Mejilla R, Ngo L, Ralston JD, et al. Inviting patients to read their doctors’ notes: a quasi-experimental study and a look ahead. Ann Intern Med. 2012;157(7):461–70.CrossRefPubMedPubMedCentral

22.

Callen J, Giardina TD, Singh H, Li L, Paoloni R, Georgiou A, Runciman WB, Westbrook JI. Emergency physicians’ views of direct notification of laboratory and radiology results to patients using the internet: a multisite survey. J Med Internet Res. 2015;17(3):e60.CrossRefPubMedPubMedCentral

23.

Miller DP Jr, Latulipe C, Melius KA, Quandt SA, Arcury TA. Primary care Providers’ views of patient portals: interview study of perceived benefits and consequences. J Med Internet Res. 2016;18(1):e8.CrossRefPubMed

24.

Kittler AF, Carlson GL, Harris C, Lippincott M, Pizziferri L, Volk LA, Jagannath Y, Wald JS, Bates DW. Primary care physician attitudes towards using a secure web-based portal designed to facilitate electronic communication with patients. Inform Prim Care. 2004;12(3):129–38.PubMed

25.

Keplinger LE, Koopman JK, Mehr DR, Kruse RL, Wakefield DS, Wakefield BJ, Canfield SM. Patient portal implementation: resident and attending physician attitudes. Fam Med. 2013;45(5):335–40.PubMed

26.

Zwaanswijk M, Verheij RA, Wiesman FJ, Friele RD. Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study. BMC Health Serv Res. 2011;11:256.CrossRefPubMedPubMedCentral

27.

Bell SK, Mejilla R, Anselmo M, Darer JD, Elmore JG, Leveille S, Ngo L, Ralston JD, Delbanco T, Walker J. When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient-doctor relationship. BMJ Qual Saf. 2016;26(4):262–70.CrossRefPubMed

28.

Kruse CS, Argueta DA, Lopez L, Nair A. Patient and provider attitudes toward the use of patient portals for the management of chronic disease: a systematic review. J Med Internet Res. 2015;17(2):e40.CrossRefPubMedPubMedCentral

29.

Campmans-Kuijpers MJ, Baan CA, Lemmens LC, Rutten GE. Change in quality management in diabetes care groups and outpatient clinics after feedback and tailored support. Diabetes Care. 2015;38:7.CrossRef

30.

Struijs JN, Baan CA. Integrating care through bundled payments - lessons from the Netherlands. N Engl J Med. 2011;364(11):2.CrossRef

31.

Rutten GEHM, De Grauw WJ, Nijpels G, Houweling ST, Van de Laar FA, Bilo H, Holleman F, Burgers JS, Wiersma TJ, PGH J. NHG-Standaard Diabetes Mellitus type 2 (derde herziening). Huisarts Wet. 2013;56(10):512–25.

32.

Weingart SN, Rind D, Tofias Z, Sands DZ. Who uses the patient internet portal? The PatientSite experience. J Am Med Inform Assoc. 2006;13(1):91–5.CrossRefPubMedPubMedCentral

33.

Grunloh C, Cajander A, Myreteg G. “The record is our work tool!”-Physicians’ framing of a patient portal in Sweden. J Med Internet Res. 2016;18(6):e167.CrossRefPubMedPubMedCentral

34.

Esch T, Mejilla R, Anselmo M, Podtschaske B, Delbanco T, Walker J. Engaging patients through open notes: an evaluation using mixed methods. BMJ Open. 2016;6(1):e010034.CrossRefPubMedPubMedCentral

35.

Schillinger D, Piette J, Grumbach K, Wang F, Wilson C, Daher C, Leong-Grotz K, Castro C, Bindman AB. Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med. 2003;163(1):83–90.CrossRefPubMed

36.

Liss DT, Reid RJ, Grembowski D, Rutter CM, Ross TR, Fishman PA. Changes in office visit use associated with electronic messaging and telephone encounters among patients with diabetes in the PCMH. Ann Fam Med. 2014;12(4):338–43.CrossRefPubMedPubMedCentral

37.

Dexter EN, Fields S, Rdesinski RE, Sachdeva B, Yamashita D, Marino M. Patient-provider communication: does electronic messaging reduce incoming telephone calls? J Am Board Fam Med. 2016;29(5):613–9.CrossRefPubMed

38.

Leveille SG, Mejilla R, Ngo L, Fossa A, Elmore JG, Darer J, Ralston JD, Delbanco T, Walker J. Do patients who access clinical information on patient internet portals have more primary care visits? Med Care. 2016;54(1):17–23.CrossRefPubMed

39.

Ronda MC, Dijkhorst-Oei LT, Rutten GE. Patients’ experiences with and attitudes towards a diabetes patient web portal. PLoS One. 2015;10(6):e0129403.CrossRefPubMedPubMedCentral

40.

Cook JV, Dickinson HO, Eccles MP. Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study. BMC Health Serv Res. 2009;9:160.CrossRefPubMedPubMedCentral

Be confident that your patient care is up to date

Medicine Matters is being incorporated into Springer Medicine, our new medical education platform.

Alongside the news coverage and expert commentary you have come to expect from Medicine Matters diabetes, Springer Medicine's complimentary membership also provides access to articles from renowned journals and a broad range of Continuing Medical Education programs. Create your free account »