Implementering af patientportaler: Forventninger og evidens - Et litteraturstudie: Hvordan implementeres patient empowerment, så det giver positive effekter (økonomiske, outcome for patienten osv.)

Implementing patient portals: Expectations and evidence - A Systematic Literature Review

Grønvald, Liselotte ; Jensen, Henrik Gaedt ; Nobel, Charlotte

2. årgang

Master i Sundhedsinformatik (Efter- og videreuddannelse)

2016

2016-06-23

Projektet undersøger, hvilke dokumenterede effekter der følger af at implementere patientportaler, og hvordan disse stemmer overens med forventningerne til MyChart i Sundhedsplatformen i Region Hovedstaden. Forfatterne gennemførte et systematisk litteraturstudie (PRISMA/PRISMA-P) af peer-reviewede artikler publiceret fra 2010 og frem (søgt i PubMed, Embase, Cinahl, LISTA, Scopus og Web of Science), hvor 1.820 titler blev screenet, 205 fuldtekstartikler vurderet, og 43 studier inkluderet. Evidensstyrken blev GRADE-inspireret vurderet som middel, og effekter blev kategoriseret i bl.a. kliniske outcomes, ressourceforbrug, adherence/compliance, patient–kliniker-kommunikation, patientempowerment, patienttilfredshed og sundhedsøkonomi (kliniker-tilfredshed blev tilføjet under syntesen). Fundene pegede hyppigst på patientempowerment (44%), patienttilfredshed (42%) og kliniske outcomes (35%), mens lavere ressourceforbrug (14%) og positive sundhedsøkonomiske effekter (7%) var mindre udbredt; risiko for ulighed blev nævnt i 45% af studierne. Efter litteraturstudiet blev en politiker, en læge og en patient med tilknytning til MyChart-implementeringen interviewet og indgik i en narrativ syntese; de forventede større gevinster i ressourceanvendelse og økonomi, end litteraturen understøtter, mens der var mere overensstemmelse om kliniske effekter, compliance og tilfredshed. Ulighed blev ikke betragtet som en væsentlig risiko af de interviewede, hvilket bekymrede politikeren. Samlet konkluderes, at evidensen for positive effekter af patientportaler er relativt svag, og at dokumenterede økonomiske gevinster er sjældne; det afspejler manglende evidens snarere end bevis for manglende effekt. Forfatterne anbefaler prioriteret forskning i økonomiske effekter og en målrettet indsats mod ulighed, så patienter med lav e-sundhedskompetence ikke ekskluderes.

This project examines the documented effects of implementing patient portals and how they align with expectations for MyChart in the Danish Sundhedsplatformen (Capital Region). The authors conducted a systematic literature review (PRISMA/PRISMA-P) of peer-reviewed studies published from 2010 onward (searching PubMed, Embase, Cinahl, LISTA, Scopus, and Web of Science), screening 1,820 titles, assessing 205 full texts, and including 43 studies. Using a GRADE-inspired approach, overall evidence strength was assessed as medium, and effects were grouped into clinical outcomes, resource use, adherence/compliance, patient–provider communication, patient empowerment, patient satisfaction, and health economics (clinician satisfaction was added during synthesis). Findings most often reported patient empowerment (44%), patient satisfaction (42%), and clinical outcomes (35%), whereas lower resource use (14%) and positive economic effects (7%) were less frequent; a risk of inequality was noted in 45% of studies. Following the review, a politician, a physician, and a patient close to the MyChart implementation were interviewed and included in a narrative synthesis; they anticipated greater resource and economic benefits than the literature supports, while there was more alignment on clinical outcomes, compliance, and satisfaction. Inequality was not seen as a major risk by interviewees, which concerned the politician. Overall, evidence for positive effects of patient portals is relatively weak, with documented economic benefits rare; this reflects a lack of evidence rather than proof of no effect. The authors recommend prioritizing research on economic impacts and addressing inequality to avoid excluding patients with low e-health literacy.

[Dette resumé er genereret med hjælp fra AI direkte fra projektet (PDF)]

Patientportal ; litteraturstudie ; implementering ; Sundhedsplatformen

Download
Vis denne rapport i AAU Studenterprojekter

Grønvald, Liselotte:

• Implementing patient portals: Expectations and evidence - A Systematic Literature Review (2016)

Jensen, Henrik Gaedt:

• Implementing patient portals: Expectations and evidence - A Systematic Literature Review (2016)

Nobel, Charlotte:

• Implementing patient portals: Expectations and evidence - A Systematic Literature Review (2016)