Improving health care proxy documentation using a web-based interview through a patient portal.

TitleImproving health care proxy documentation using a web-based interview through a patient portal.
Publication TypeJournal Article
Year of Publication2016
AuthorsBajracharya AS, Crotty BH, Kowaloff HB, Safran C, Slack WV
JournalJ Am Med Inform Assoc
Volume23
Issue3
Pagination580-7
Date Published2016 05
ISSN1527-974X
KeywordsAdult, Aged, Chi-Square Distribution, Documentation, Electronic Health Records, Female, Humans, Internet, Interviews as Topic, Male, Middle Aged, Patient Portals, Proxy, Young Adult
Abstract

OBJECTIVE: Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR).METHODS: We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods.RESULTS: From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45-67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, Pā€‰=ā€‰.005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP.CONCLUSIONS: Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient's HCP information is both feasible and useful.

DOI10.1093/jamia/ocv133
Alternate JournalJ Am Med Inform Assoc
PubMed ID26568608
PubMed Central IDPMC4901371
Grant ListR01 HS021495 / HS / AHRQ HHS / United States
T15 LM007092 / LM / NLM NIH HHS / United States
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