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Understanding of and Barriers to Electronic Health Record Patient Portal Access in a Culturally Diverse Pediatric Population

机译：在文化多样化的儿科人口中了解电子健康记录患者门户网站通道的理解

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Electronic health records (EHRs) have become a standard in the health care setting. In an effort to improve health literacy, foster doctor-patient communication, and ease the transition from adolescent to adult care, our institution created a policy that allows patients aged between 13 and 17 years to have EHR portal access. A literature review revealed predictable differences in portal registration among different ethnicities and socioeconomic statuses. Consequently, a cross-sectional survey was developed to investigate barriers to EHR portal access in a sample of culturally diverse adolescents. The aim of this study was to assess for barriers to EHR portal access in a culturally diverse adolescent population. A 42-item anonymous survey was completed by 97 adolescents aged between 13 and 18 years, attending general pediatrics clinics. The results were analyzed using descriptive statistics and t tests. The average participant age was 15.5 (SD 1.5) years with 60% (58/97) male and 40% (39/97) female. Participants were 44% (43/97) black, 41% (40/97) Hispanic, 9% (9/97) Caucasian, 3% (3/97) Asian, and 2% (2/97) others. There were statistically significant differences in perceptions of confidentiality in age (13 to 15 years vs 16 to 18 years; P=.001) and insurance status (government vs private; P=.012) but not in gender, ethnicity, or parental education level. Younger adolescents with governmental insurance were more confident in the level of confidentiality with their physician. A total of 94% of participants had heard of the term EHR, but only 55% were familiar with its function. Furthermore, 77% of patients primarily accessed the internet through phones, and 50% of participants knew that patients aged under 18 years could obtain care for mental health, substance abuse, sexual health, and pregnancy. This research has identified gaps in EHR technology with regard to the pediatric patient population. The results of our survey show that adolescents may have misconceptions regarding the doctor-patient relationship, their ability to obtain care, and the modalities present in an EHR. As technology progresses, it is essential to have a deeper understanding of adolescents' perceptions of confidentiality, technology, and available resources to design an EHR system that encourages patient education and communication while limiting barriers to care. ?Daniel J Miklin, Sameera S Vangara, Alan M Delamater, Kenneth W Goodman. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 26.04.2019.
机译：电子健康记录（EHRS）已成为医疗保健环境的标准。为了提高健康识字，促进医生沟通，并缓解了从青少年到成人护理的过渡，我们的机构创造了一个允许13至17岁的患者获得EHR门户网站的政策。文献综述揭示了不同种族和社会经济地位的门户登记的可预测差异。因此，开发了一种横断面调查，以研究在文化多样化的青少年样本中的EHR门户网站访问的障碍。本研究的目的是在文化多样化的青少年人口中评估EHR门户网站访问的障碍。参加通用儿科诊所，在13至18岁之间完成了42件匿名调查。使用描述性统计和T测试分析结果。平均参与者年龄为15.5（SD 1.5）年，60％（58/97）男性和40％（39/97）女性。参与者是44％（43/97）黑色，41％（40/97）西班牙裔，9％（9/97）白种人，3％（3/97）亚洲人，2％（2/97）其他。在年龄的机密性感知（13至15岁与16至18岁之间的情况存在统计学意义差异（13至15岁; P = .001）和保险状况（政府与私人; P = .012），但不是性别，种族或父母教育等级。具有政府保险的年轻青少年在与他们的医生的机密程度更加自信。总共有94％的参与者听说过EHR的术语，但只有55％熟悉其功能。此外，77％的患者主要通过电话访问互联网，50％的参与者知道18岁以下的患者可以获得心理健康，药物滥用，性健康和怀孕的护理。该研究已经确定了EHR技术的差距，关于儿科患者人口。我们的调查结果表明，青少年可能对医生关系有误解，他们获得护理的能力，以及在EHR中存在的方式。随着技术的进展，必须深入了解青少年对机密性，技术和可用资源的看法，以设计一个鼓励患者教育和沟通的EHR系统，同时限制关心的障碍。 ？Daniel J Miklin，Sameera S Vangara，Alan M Delamater，Kenneth W Goodman。最初发表在JMIR医疗信息学（http://medinform.jmir.org），26.04.2019。

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