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Khadjesari, Zarnie 
ORCID: https://orcid.org/0000-0002-2958-9555, Houghton, Julie, Brown, Tracey J., Jopling, Helena, Stevenson, Fiona and Lynch, Jennifer
(2023)
Contextual factors that impact the implementation of patient portals with a focus on older people in acute care hospitals: Scoping review.
JMIR Aging, 6 (6).
ISSN 2561-7605
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Abstract
Background: Older people are the highest users of health services but are less likely to use a patient portal than younger people. Objective: This scoping review aimed to identify and synthesize the literature on contextual factors that impact the implementation of patient portals in acute care hospitals and among older people. Methods: A scoping review was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. The following databases were searched from 2010 to June 2020: MEDLINE and Embase via the Ovid platform, CINAHL and PsycINFO via the EBSCO platform, and the Cochrane Library. Eligible reviews were published in English; focused on the implementation of tethered patient portals; included patients, health care professionals, managers, and budget holders; and aimed at identifying the contextual factors (ie, barriers and facilitators) that impact the implementation of patient portals. Review titles and abstracts and full-text publications were screened in duplicate. The study characteristics were charted by one author and checked for accuracy by a second author. The NASSS (Non-adoption, Abandonment, Scale-up, Spread, and Sustainability) framework was used to synthesize the findings. Results: In total, 10 systematic reviews published between 2015 and 2020 were included in the study. Of these, 3 (30%) reviews addressed patient portals in acute care hospitals, and 2 (20%) reviews addressed the implementation of patient portals among older people in multiple settings (including acute care hospitals). To maximize the inclusion of the literature on patient portal implementation, we also included 5 reviews of systematic reviews that examined patient portals in multiple care settings (including acute care hospitals). Contextual factors influencing patient portal implementation tended to cluster in specific NASSS domains, namely the condition, technology, and value proposition. Certain aspects within these domains received more coverage than others, such as sociocultural factors and comorbidities, the usability and functionality aspects of the technology, and the demand-side value. There are gaps in the literature pertinent to the consideration of the provision of patient portals for older people in acute care hospitals, including the lack of consideration of the diversity of older adults and their needs, the question of interoperability between systems (likely to be important where care involves multiple services), the involvement of lay caregivers, and looking beyond short-term implementation to ways in which portal use can be sustained. Conclusions: We identified important contextual factors that impact patient portal implementation and key gaps in the literature. Future research should focus on evaluating strategies that address disparities in use and promote engagement with patient portals among older people in acute care settings.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding Information: The research was funded by UEA Health and Social Care Partners (UEAHSCP). This is a summary of the research supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East of England. JL (NIHR Knowledge Mobilisation Research Fellow KMRF-2017-06-ST2-006) was funded by the NIHR for this research project. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, the National Health Service, or the UK Department of Health and Social Care. FS is the deputy lead for the Innovation and Implementation Science theme at the Applied Research Collaboration North Thames. |
| Uncontrolled Keywords: | acute care hospitals,implementation,patient portal,scoping review,tethered personal health records,health(social science),gerontology,health informatics,geriatrics and gerontology ,/dk/atira/pure/subjectarea/asjc/3300/3306 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > School of Health Sciences Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Behavioural and Implementation Science Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 07 Feb 2023 12:31 |
| Last Modified: | 19 Oct 2023 03:32 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/91062 |
| DOI: | 10.2196/31812 |
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