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首页> 外文期刊>Journal of medical Internet research >The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study
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The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

机译：回顾性研究：使用电子病历患者门户网站访问学术医疗中心急诊患者的诊断测试结果

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Background Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients. Objective The study aimed to assess patient portal utilization by ED patients at an academic medical center using account activation rates along with the rates of access of diagnostic test results (laboratory results and radiology reports), analyzing the impact of age, gender, and self-reported patient race. Methods This institutional review board–approved retrospective study was performed at a 60,000-visits-per-year university-based ED. We utilized EHR data reporting tools to examine EHR portal activation and utilization for all patients who had at least one ED encounter with one or more diagnostic tests performed between October 1, 2016, and October 1, 2017. The total dataset for laboratory testing included 208,635 laboratory tests on 25,361 unique patients, of which 9482 (37.39%) had active portal accounts. The total dataset for radiologic imaging included 23,504 radiology studies on 14,455 unique patients, of which 5439 (37.63%) had an active portal account. Results Overall, 8.90% (18,573/208,635) of laboratory tests and 8.97% (2019/22,504) of radiology reports ordered in the ED were viewed in the patient portal. The highest rates of viewing of laboratory and radiology results were seen for those who were female, were aged 0 to 11 years (parent or guardian viewing by proxy) and 18 to 60 years, and self-reported their race as Caucasian or Asian. The lowest rates were for those who were teenagers, aged older than 81 years, African American/black, and Hispanic/Latino. Infectious disease, urinalysis, and pregnancy testing constituted the highest number of laboratory tests viewed. Magnetic resonance imaging reports were viewed at higher rates than computed tomography or x-ray studies ( P &.001). Approximately half of all the diagnostic test results accessed by patients were reviewed within 72 hours of availability in the patient portal (laboratory results: 9904/18,573, 53.32% and radiology reports: 971/2019, 48.1%). On the other extreme, 19.9% (3701/18,573) of laboratory results and 31.6% (639/2019) of radiology reports were viewed more than 2 weeks after availability in the portal. Conclusions The data highlight the relatively low use of a patient portal by ED patients and existing disparities between patient groups. There can be wide lag time (months) between result/report availability and access by patients. Opportunities for improvement exist for both activation and more robust utilization of patient portals by ED patients.
机译：背景技术电子健康记录（EHR）患者门户网站提供了一种使患者可以访问其健康信息（包括诊断测试结果）的方法。对于急诊科（ED）患者使用门户的情况知之甚少。目的这项研究旨在通过账户激活率以及诊断测试结果（实验室结果和放射学报告）的访问率来评估学术医疗中心的ED患者对患者门户的利用情况，分析年龄，性别和自我诊断的影响。报告患者种族。方法：该方法是由机构审查委员会批准的一项回顾性研究，是在每年以大学为基础的ED研究中进行的，每年访问量为60,000次。我们使用EHR数据报告工具检查了2016年10月1日至2017年10月1日之间至少经历过一次ED的一项或多项诊断测试的所有患者的EHR门户激活和利用率。实验室测试的总数据集包括208,635对25,361名独特患者的实验室检测，其中9482（37.39％）名具有活跃门户网站帐户。放射成像的整个数据集包括针对14,455名独特患者的23,504项放射学研究，其中5439（37.63％）个患者拥有活跃的门户帐户。结果总体而言，在患者门户网站中查看了急诊室订购的8.90％（18,573 / 208,635）实验室检查和8.97％（2019 / 22,504）放射学报告。女性，年龄在0到11岁（通过代理人父母或监护人观看）和18到60岁，并且自我报告其种族为白种人或亚洲的女性中，对实验室和放射学结果的观看率最高。发生率最低的是年龄在81岁以上的青少年，非裔美国人/黑人和西班牙裔/拉丁美洲人。传染病，尿液分析和妊娠试验构成了实验室检查次数最多的一项。磁共振成像报告的观看率高于计算机断层扫描或X射线研究（P <.001）。在患者门户网站可用的72小时内，对患者获得的所有诊断测试结果中的大约一半进行了检查（实验室结果：9904 / 18,573，占53.32％，放射学报告：971/2019，占48.1％）。在另一个极端中，在门户网站可用后超过2周，查看了19.9％（3701 / 18,573）的实验室结果和31.6％（639/2019）的放射学报告。结论数据突显了ED患者使用患者门户的比例相对较低，并且患者群体之间存在差异。结果/报告可用性与患者获取之间可能会有很长的延迟时间（数月）。 ED患者既有激活机会又能更可靠地利用患者门脉的机会。

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