PDF(Pubmed)
Abstract：
The patient portal is a widely available secure digital platform offered by care delivery organizations that enables patients to communicate electronically with clinicians and manage their care. Many organizations allow patients to authorize family members or friends-\"care partners\"-to share access to patient portal accounts, thus enabling care partners to receive their own identity credentials. Shared access facilitates trilateral information exchange among patients, clinicians, and care partners; however, uptake and awareness of this functionality are limited.
We partnered with 3 health care organizations to co-design an initiative that aimed to increase shared access registration and use and that can be implemented using existing patient portals.
In 2020, we undertook a rigorous selection process to identify 3 geographically diverse health care organizations that had engaged medical informatics teams and clinical champions within service delivery lines caring for older adults. We prioritized selecting organizations that serve racially and socioeconomically diverse populations and possess sophisticated reporting capabilities, a stable patient portal platform, a sufficient volume of older adult patients, and active patient and family advisory councils. Along with patients and care partners, clinicians, staff, and other stakeholders, the study team co-designed an initiative to increase the uptake of shared access guided by either an iterative, human-centered design process or rapid assessment procedures of stakeholders\' inputs.
Between February 2020 and April 2022, 73 stakeholder engagements were conducted with patients and care partners, clinicians and clinic staff, medical informatics teams, marketing and communications staff, and administrators, as well as with funders and thought leaders. We collected insights regarding (1) barriers to awareness, registration, and use of shared access; (2) features of consumer-facing educational materials to address identified barriers; (3) features of clinician- and staff-facing materials to address identified barriers; and (4) approaches to fit the initiative into current workflows. Using these inputs iteratively via a human-centered design process, we produced brochures and posters, co-designed organization-specific web pages detailing shared access registration processes, and developed clinician and staff talking points about shared access and staff tip sheets that outline shared access registration steps. Educational materials emphasized the slogan \"People remember less than half of what their doctors say,\" which was selected from 9 candidate alternatives as resonating best with the full range of the initiative\'s stakeholders. The materials were accompanied by implementation toolkits specifying and reinforcing workflows involving both in-person and telehealth visits.
Meaningful and authentic stakeholder engagement allowed our deliberate, iterative, and human-centered co-design aimed at increasing the use of shared access. Our initiative has been launched as a part of a 12-month demonstration that will include quantitative and qualitative analysis of registration and use of shared access. Educational materials are publicly available at Coalition for Care Partners.
We partnered with 3 health care organizations to co-design an initiative that aimed to increase shared access registration and use and that can be implemented using existing patient portals.
In 2020, we undertook a rigorous selection process to identify 3 geographically diverse health care organizations that had engaged medical informatics teams and clinical champions within service delivery lines caring for older adults. We prioritized selecting organizations that serve racially and socioeconomically diverse populations and possess sophisticated reporting capabilities, a stable patient portal platform, a sufficient volume of older adult patients, and active patient and family advisory councils. Along with patients and care partners, clinicians, staff, and other stakeholders, the study team co-designed an initiative to increase the uptake of shared access guided by either an iterative, human-centered design process or rapid assessment procedures of stakeholders\' inputs.
Between February 2020 and April 2022, 73 stakeholder engagements were conducted with patients and care partners, clinicians and clinic staff, medical informatics teams, marketing and communications staff, and administrators, as well as with funders and thought leaders. We collected insights regarding (1) barriers to awareness, registration, and use of shared access; (2) features of consumer-facing educational materials to address identified barriers; (3) features of clinician- and staff-facing materials to address identified barriers; and (4) approaches to fit the initiative into current workflows. Using these inputs iteratively via a human-centered design process, we produced brochures and posters, co-designed organization-specific web pages detailing shared access registration processes, and developed clinician and staff talking points about shared access and staff tip sheets that outline shared access registration steps. Educational materials emphasized the slogan \"People remember less than half of what their doctors say,\" which was selected from 9 candidate alternatives as resonating best with the full range of the initiative\'s stakeholders. The materials were accompanied by implementation toolkits specifying and reinforcing workflows involving both in-person and telehealth visits.
Meaningful and authentic stakeholder engagement allowed our deliberate, iterative, and human-centered co-design aimed at increasing the use of shared access. Our initiative has been launched as a part of a 12-month demonstration that will include quantitative and qualitative analysis of registration and use of shared access. Educational materials are publicly available at Coalition for Care Partners.
摘要：
患者门户是由护理交付组织提供的广泛可用的安全数字平台，使患者能够与临床医生进行电子通信并管理他们的护理。许多组织允许患者授权家庭成员或朋友-“护理合作伙伴”-共享对患者门户帐户的访问权限，从而使护理伙伴能够获得自己的身份凭证。共享访问促进了患者之间的三边信息交流，临床医生,和护理伙伴；然而，这种功能的吸收和认识是有限的。
我们与3个医疗机构合作，共同设计了一项旨在提高共享访问注册和使用的计划，该计划可以使用现有的患者门户来实施。
在2020年，我们进行了严格的选择过程，以确定3个地理上不同的医疗保健组织，这些组织在照顾老年人的服务交付线中聘请了医学信息学团队和临床冠军。我们优先选择服务于种族和社会经济多样化人群并拥有复杂报告能力的组织，一个稳定的病人入口平台，足够的老年患者，和积极的病人和家庭咨询委员会。与患者和护理伙伴一起，临床医生,工作人员,和其他利益相关者，研究小组共同设计了一项倡议，以增加在迭代指导下的共享访问，以人为本的设计过程或利益相关者输入的快速评估程序。
在2020年2月至2022年4月之间，与患者和护理合作伙伴进行了73项利益相关者参与。临床医生和诊所工作人员，医学信息学团队，营销和传播人员，和管理员，以及资助者和思想领袖。我们收集了关于(1)意识障碍的见解，注册，和共享访问的使用；（2）面向消费者的教育材料的特征，以解决已识别的障碍；（3）面向临床和员工的材料的特征，以解决已识别的障碍；（4）将倡议融入当前工作流程的方法。通过以人为本的设计过程迭代地使用这些输入，我们制作了小册子和海报，共同设计的特定于组织的网页，详细说明共享访问注册过程，并制定了临床医生和员工关于共享访问的谈话要点以及概述共享访问注册步骤的员工提示表。教育材料强调了这样的口号：“人们记得不到医生所说的话的一半，“从9个候选替代方案中选出，与该计划的所有利益相关者产生了最好的共鸣。这些材料附有实施工具包，具体说明和加强涉及亲自和远程保健访问的工作流程。
有意义和真实的利益相关者参与允许我们深思熟虑，迭代，和以人为中心的共同设计，旨在增加共享访问的使用。我们的倡议已作为12个月示范的一部分启动，该示范将包括对共享访问的注册和使用的定量和定性分析。教育材料可在关爱伙伴联盟公开获得。
我们与3个医疗机构合作，共同设计了一项旨在提高共享访问注册和使用的计划，该计划可以使用现有的患者门户来实施。
在2020年，我们进行了严格的选择过程，以确定3个地理上不同的医疗保健组织，这些组织在照顾老年人的服务交付线中聘请了医学信息学团队和临床冠军。我们优先选择服务于种族和社会经济多样化人群并拥有复杂报告能力的组织，一个稳定的病人入口平台，足够的老年患者，和积极的病人和家庭咨询委员会。与患者和护理伙伴一起，临床医生,工作人员,和其他利益相关者，研究小组共同设计了一项倡议，以增加在迭代指导下的共享访问，以人为本的设计过程或利益相关者输入的快速评估程序。
在2020年2月至2022年4月之间，与患者和护理合作伙伴进行了73项利益相关者参与。临床医生和诊所工作人员，医学信息学团队，营销和传播人员，和管理员，以及资助者和思想领袖。我们收集了关于(1)意识障碍的见解，注册，和共享访问的使用；（2）面向消费者的教育材料的特征，以解决已识别的障碍；（3）面向临床和员工的材料的特征，以解决已识别的障碍；（4）将倡议融入当前工作流程的方法。通过以人为本的设计过程迭代地使用这些输入，我们制作了小册子和海报，共同设计的特定于组织的网页，详细说明共享访问注册过程，并制定了临床医生和员工关于共享访问的谈话要点以及概述共享访问注册步骤的员工提示表。教育材料强调了这样的口号：“人们记得不到医生所说的话的一半，“从9个候选替代方案中选出，与该计划的所有利益相关者产生了最好的共鸣。这些材料附有实施工具包，具体说明和加强涉及亲自和远程保健访问的工作流程。
有意义和真实的利益相关者参与允许我们深思熟虑，迭代，和以人为中心的共同设计，旨在增加共享访问的使用。我们的倡议已作为12个月示范的一部分启动，该示范将包括对共享访问的注册和使用的定量和定性分析。教育材料可在关爱伙伴联盟公开获得。
