Patient Perspectives on Advance Care Planning via a Patient Portal.
Adult
Advance Care Planning
/ organization & administration
Aged
Aged, 80 and over
Electronic Health Records
/ organization & administration
Electronic Mail
/ organization & administration
Female
Humans
Male
Middle Aged
Patient Education as Topic
/ organization & administration
Patient Portals
/ statistics & numerical data
Qualitative Research
advance care planning
advance directive
electronic health record
health information technology
patient portal
qualitative
Journal
The American journal of hospice & palliative care
ISSN: 1938-2715
Titre abrégé: Am J Hosp Palliat Care
Pays: United States
ID NLM: 9008229
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
pubmed:
26
2
2019
medline:
30
1
2020
entrez:
27
2
2019
Statut:
ppublish
Résumé
Patient portals can offer patients an opportunity to engage in the advance care planning (ACP) process outside of clinical visits. To describe patient perspectives on use of patient portal-based ACP tools. Interviews with patients who used portal-based ACP tools. The tools included an electronic Medical Durable Power of Attorney (MDPOA) form to designate a medical decision maker, a patient-centered educational web page, online messaging, and patient access to completed advance directives stored in the electronic health record (EHR). Regional health-care system with a common EHR. Semistructured interviews with purposefully sampled patients who used the ACP tools. Questions explored motivations for using the tools and perceptions about how the tools fit into ACP. Analysis followed a grounded hermeneutic editing approach. From 46 patients (mean age: 49, 63% female), 4 key themes emerged: (1) individualized explorations of the ACP tools, (2) personal initiation and engagement with ACP tools through the portal, (3) value of connecting ACP portal tools to clinical care, and (4) practicality of the ACP tools. Patients described benefits of communicating with health-care team members who referred them to online ACP tools, as well as having the electronic MDPOA form connected to clinical care. Patients considered the portal-based ACP tools to be practical and feasible to use within the scope of their own ACP experiences. Further study is needed to understand whether portal-based ACP tools increase the quality and quantity of ACP conversations and documentation that is available to inform medical decision-making.
Sections du résumé
BACKGROUND
BACKGROUND
Patient portals can offer patients an opportunity to engage in the advance care planning (ACP) process outside of clinical visits.
OBJECTIVE
OBJECTIVE
To describe patient perspectives on use of patient portal-based ACP tools.
DESIGN
METHODS
Interviews with patients who used portal-based ACP tools. The tools included an electronic Medical Durable Power of Attorney (MDPOA) form to designate a medical decision maker, a patient-centered educational web page, online messaging, and patient access to completed advance directives stored in the electronic health record (EHR).
SETTING
METHODS
Regional health-care system with a common EHR.
MEASUREMENTS
METHODS
Semistructured interviews with purposefully sampled patients who used the ACP tools. Questions explored motivations for using the tools and perceptions about how the tools fit into ACP. Analysis followed a grounded hermeneutic editing approach.
RESULTS
RESULTS
From 46 patients (mean age: 49, 63% female), 4 key themes emerged: (1) individualized explorations of the ACP tools, (2) personal initiation and engagement with ACP tools through the portal, (3) value of connecting ACP portal tools to clinical care, and (4) practicality of the ACP tools. Patients described benefits of communicating with health-care team members who referred them to online ACP tools, as well as having the electronic MDPOA form connected to clinical care.
CONCLUSIONS
CONCLUSIONS
Patients considered the portal-based ACP tools to be practical and feasible to use within the scope of their own ACP experiences. Further study is needed to understand whether portal-based ACP tools increase the quality and quantity of ACP conversations and documentation that is available to inform medical decision-making.
Identifiants
pubmed: 30803245
doi: 10.1177/1049909119832820
pmc: PMC6602833
mid: NIHMS1021001
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
682-687Subventions
Organisme : NIA NIH HHS
ID : K76 AG054782
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR025780
Pays : United States
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