Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018). Patient Portal Use in Diabetes Management: Literature Review. JMIR diabetes, 3(4), e11199. https://doi.org/10.2196/11199
Sun et al. (2018) examined the association of the patient portal use with diabetes outcomes and opportunities for the management of diabetes. The study utilized 30 articles 6 of which were randomized controlled trials, 16 observational studies, 4 qualitative studies, and 4 mixed studies. The features offered in the portals varied across systems with a majority of the portals visited allowing the patients to access visitation summary, medical history, lab results and physical examination results, general health education, communication with the healthcare providers, prescription refills. For patients with diabetes, the portals allowed the patients to upload their blood glucose readings accessed from their home-monitoring devices. The portals similarly provided patient-centered education based on the patient’s conditions. Some of the portals similarly allowed patients to key in their lifestyle information such as dietary habits and physical exercise habits.
The review indicates that the percentage of the patients that registered for the portal was 29 to 46 percent. 27 to 76 percent of the patients with portal accounts logged onto their portals. The patient’s usage of the portals mostly was to view laboratory results, followed by requests for medication refills, sending and reading of messages, and making appointments. The study indicates that the patients who had access to the web-based portals recorded lower glycemic levels as well as better control of their LDL. Other portal uses like the request of prescription refills were associated with the decline of LDL and BP levels. The study, therefore, indicates that the use of the patient portals resulted in better management of diabetes among the patients and control of their patient’s health care outcomes.
Reed M.E., Huang J., Brand RJ, Neugebauer R., Graetz I., Hsu J., et al. (2019) Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal. PLoS ONE 14(6): e0217636. https://doi.org/10.1371/journal.pone.0217636
Reed et al. (2019) aimed at examining the impact of portal access on the number of outpatient visits, preventable hospitalizations, and emergency visits among the patients. The observational study compared the visit rates with and without portal access. The setting was a large integrated delivery system, which implemented the patient portal between 2006 and 2007. The study utilized the clinical patient history information captured in the electronic health record on outpatient office visits emergency department visits and preventable hospitalizations.
The study findings indicate that patients that had more access to the portal experienced fewer emergency department visits at a rate of 3.5 per 1000 patients and preventable hospital stays at the rate of 0.8 per 1000 patients. The study indicates that patients with diabetes had more office visits after accessing the portal, which facilitated the self-management of the disease. The study also found out that ore office visits resulted in fewer admissions to the emergency departments as the patients would monitor and regulate their healthcare outcomes lowering their chance of suffering adverse events and health complications.
Diabetes being a multi-factorial disease requires the adoption of a multifaceted approach for its management and overall prevention of healthcare complications. The article, therefore, indicates the use of the patient portals results in better management of diabetes symptoms and self-management skills among the patents. The portals, therefore, facilitate the patients to access patient education, prescription refills, and consultations with the physicians resulting in better management of their healthcare outcomes.
Graetz, I., Huang, J., Muelly, E. R., Fireman, B., Hsu, J., & Reed, M. E. (2020). Association of mobile patient portal access with diabetes medication adherence and glycemic levels among adults with diabetes. JAMA Network Open, 3(2), e1921429-e1921429. doi: 10.1001/jamanetworkopen.2019.21429
Graetz et al. (2020) aimed at investigating if the mobile access to the patient portal is associated with improved outcomes among patients with diabetes. The retrospective cohort study included patients diagnosed with diabetes and treated in the Kaiser Permanente Northern California between April 2015 and December 2017. The study subjects are 18-year old individuals with t
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