Patient Portals in Evidence-Based Practice

What is the PICOT question?

In patients in a primary care office (P), does having an accessible and functioning patient portal (I), compared with not having a patient portal, only records provided as requested during office visits (C), improve compliance to plan of care from PCP (O), in 6 months (T)?

  • P- (Patient, population, or problem): Patients in a primary care office
  • I (Intervention): Accessible and functioning patient portal
  • C- (Comparison with other treatment/current practice): Not having a patient portal – only records provided as requested during office visits.
  • O- (Desired outcome): Improved compliance to plan of care from PCP
  • T- (Time Frame): 6 months

What is the practice issue/problem? What is the scope of the issue? What is the need for change?

The practice complies with to plan of care from primary care providers. The traditional way of patient engagement where records are provided as requested during office visits affects compliance levels. This assertion holds because patients can only access their information when they visit health care facilities. However, with functioning patient portals, users can access their information remotely at the convenience of their homes.

As such, patients are more likely to follow treatment plans because they can log in at any time and view instructions and plans given by primary care providers. According to Irizarry, DeVito Dabbs, and Curran (2015), patient portals allow a patient-centric approach to health care provision whereby patients are involved in their own care by making informed decisions and taking appropriate actions to achieve the desired outcomes. Neves et al. (2018) add functioning patient portals create a system through which health care professionals, patients, family members work together within a framework of organizational procedures and policies to enhance the inclusion of patients as partners in the provision of care services.

Therefore, the scope of this issue covers the engagement and inclusion of patients and their family members in the provision of health care services for improved compliance to care plans. The merits of having a functional patient portal necessitate the need for change to ensure that patients become active partners in providing care for improved outcomes. When patients comply to care plans, they are likely to benefit from the set treatment and medication protocols, and thus their health is restored in time. However, without compliance, some health conditions may deteriorate and lead to chronic states, which could be avoided. These arguments underscore the need for practice change to have functional patient portals to foster compliance to care plans by primary care providers.

What is the practice area?

  • Clinical
  • Administration

How was the practice issue identified?

  • Safety/risk management concerns
  • Unsatisfactory patient outcomes
  • Significant financial concerns
  • Clinical practice issue is a concern

What evidence must be gathered?

Various sources, including literature search, clinical expertise, expert opinion, and standards, would be used to gather evidence on the issue under study. The first source is a literature search to establish what the available documented research works say about having functional patient portals and the effect of the same on patient compliance to instructions by PCP. Clinical expertise would also be sought to hear from PCPs who are already using patient portals.

This primary source of information would be important as it offers evidence-based data. Similarly, expert opinion on the issue would play a critical role in hearing what different experts have to say concerning the issue. The final source of information would be standards to find out whether there are regulatory provisions governing the implementation of patient portals in the process of care provision.

  • Literature search
  • Expert Opinion
  • Clinical Expertise
  • Standards (Regulatory, professional, community)

Search terms/How to narrow the search?

The search terms will include patient portals, compliance to care plans, primary care providers.

Conducting a search on databases, such as PubMed and CINAHL, would yield numerous results on the topic that should be filtered to select only the relevant and useful ones. The search would be narrowed by focusing on peer-reviewed articles with the majority of matching words, and specifically the search words forming phrases. Besides, the search would be limited to articles published in the last five years to ensure that the information is up-to-date and relevant.

References

Irizarry, T., DeVito Dabbs, A., & Curran, C. R. (2015). Patient portals and patient engagement: A state of the science review. Journal of Medical Internet Research, 17(6), 1-14. Web.

Neves, A. L., Carter, A. W., Freise, L., Laranjo, L., Darzi, A., & Mayer, E. K. (2018). Impact of sharing electronic health records with patients on the quality and safety of care: A systematic review and narrative synthesis protocol. BMJ Open, 8(8), 1-8. Web.

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