Identifying the role of inpatient portals to support health literacy: Perspectives from patients and care team members

Enabling awareness, agency and participation: Haematology patient experiences of an (in)patient portal's information affordances

This study examines patient experiences of an inpatient portal's information affordances, including access to results, notes, vital signs, medication information and a schedule. Patient participants were recruited from an inpatient ward primarily catering to patients with haematological malignancies including leukaemia and bone marrow transplant recipients at the Royal Melbourne Hospital. Although focused on the inpatient experience of a portal's information affordances accessed via a hospital-provided tablet, due to limited patient access to notes in the inpatient context, this study also explored patient experiences of their outpatient portal notes accessed via their smartphone. This study demonstrates the value of an (in)patient portal in enabling patient awareness, agency and participation in their care. It shows how an (in)patient portal not only helps patients make informed decisions in their care, but can also initiate patient conversation and collaboration with clinicians. This study points how the digital mediation of healthcare can provide greater transparency in the patient-clinician relationship and address the information asymmetry that typically characterises this relationship, particularly in the Australian context, where inpatient portals are still in their infancy.

Improving Provisioning of an Inpatient Portal: Perspectives from Nursing Staff

BACKGROUND

 Inpatient portals are recognized to provide benefits for both patients and providers, yet the process of provisioning tablets to patients by staff has been difficult for many hospitals.

OBJECTIVE

 Our study aimed to identify and describe practices important for provisioning an inpatient portal from the perspectives of nursing staff and provide insight to enable hospitals to address challenges related to provisioning workflow for the inpatient portal accessible on a tablet.

METHODS

 Qualitative interviews were conducted with 210 nursing staff members across 26 inpatient units in six hospitals within The Ohio State University Wexner Medical Center (OSUWMC) following the introduction of tablets providing access to an inpatient portal, MyChart Bedside (MCB). Interviews asked questions focused on nursing staffs' experiences relative to MCB tablet provisioning. Verbatim interview transcripts were coded using thematic analysis to identify factors associated with tablet provisioning. Unit provisioning performance was established using data stored in the OSUWMC electronic health record about provisioning status. Provisioning rates were divided into tertiles to create three levels of provisioning performance: (1) higher; (2) average; and (3) lower.

RESULTS

 Three themes emerged as critical strategies contributing to MCB tablet provisioning success on higher-performing units: (1) establishing a feasible process for MCB provisioning; (2) having persistent unit-level MCB tablet champions; and (3) having unit managers actively promote MCB tablets. These strategies were described differently by staff from the higher-performing units when compared with characterizations of the provisioning process by staff from lower-performing units.

CONCLUSION

 As inpatient portals are recognized as a powerful tool that can increase patients' access to information and enhance their care experience, implementing the strategies we identified may help hospitals' efforts to improve provisioning and increase their patients' engagement in their health care.