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Patient-Perceived Facilitators of and Barriers to Electronic Portal Use: A Systematic Review

CIN: Computers, Informatics, Nursing: November 2017 - Volume 35 - Issue 11 - p 606–607
doi: 10.1097/01.NCN.0000527202.35010.77
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CE TEST QUESTIONS

GENERAL PURPOSE: To describe the characteristics of portal users and their perception of the emerging technology utilizing a systematic literature review.

LEARNING OBJECTIVES/OUTCOMES: After completing this educational activity, you should be able to:

1. Define the concept and principles of meaningful use.

2. Identify the methods utilized to systematically review the relevant literature.

3. Identify the results and implications of the literature review regarding characteristics of portal users.

  1. What is the driving force behind expanded portal adoption?
    1. grassroots efforts
    2. third-party payer requirements
    3. the federal Electronic Health Record (EHR) Incentive Program
  2. Meaningful use (MU) was designed by the Centers for Medicare & Medicaid Services (CMS) to encourage adoption, implementation, and use of
    1. electronic billing.
    2. EHRs to improve patient care.
    3. technology to improve communication.
  3. The proposed rule for MU Stage 3 received criticism due to the rule's
    1. limited application to certain physician groups.
    2. failure to provide adequate definitions of requirements.
    3. lack of flexibility and payment adjustments.
  4. Beginning in what year are all providers required to report on the same definition of MU at stage 3?
    1. 2017
    2. 2018
    3. 2019
  5. The Quality Payment Program authorizes CMS to measure performance through
    1. voluntary patient evaluation.
    2. third-party evaluation metrics.
    3. a Merit-Based Incentive Payment System.
  6. Studies indicate that the volume of patient use of the electronic patient portal technology is
    1. high.
    2. low.
    3. difficult to measure.
  7. The literature review was limited to studies published between
    1. 2009 and 2016.
    2. 2001 and 2009.
    3. prior to 2001.
  8. Which study type was included in the literature search?
    1. studies published in any journal addressing patient portal use
    2. empirical studies in English-language peer-reviewed journals
    3. descriptive studies in nursing journals
  9. How many studies were included in the final review?
    1. 37
    2. 58
    3. 163
  10. The review indicated that characteristics of portal users have been described according to three broad categories: demographic characteristics, patterns of use, and
    1. relationships with healthcare providers.
    2. level of education and socioeconomic group.
    3. complexity and duration of disease.
  11. The most commonly explored demographic variables were
    1. insurance type and age.
    2. gender, age, and race.
    3. size of household and zip code.
  12. In the study by Jones et al, the most prevalent user groups included those who
    1. spent a short amount of time in the portal.
    2. used the portal consistently every day.
    3. understood the link between portal use and outcomes.
  13. Buist et al found that, among early adopters, the patients who were more likely to be portal users were those who
    1. had recently been hospitalized.
    2. were newly diagnosed as having a chronic illness.
    3. had recently had a well-patient visit.
  14. Phelps et al found provider encouragement and assistance with the first login resulted in improved use of the portal
    1. for secure messaging only.
    2. after 3 years.
    3. among users older than 65 years specifically.
  15. Findings from the study by Lyles et al revealed a positive association between being a registered portal user and
    1. compliance with the prescribed healthcare regimen.
    2. duration of the patient-provider relationship.
    3. trust in the healthcare provider.
  16. What was the most consistent perceived barrier to portal use?
    1. technical difficulties accessing or navigating the portal
    2. lack of awareness of the portal
    3. concerns about confidentiality
  17. A consistent limitation throughout the review, as identified by the author, was the
    1. limited number of studies appropriate for inclusion.
    2. failure of MU to address long-term sustainability.
    3. lack of theoretical framework and inconsistent conceptual definitions.
  18. The author argues that further development of a conceptual framework is necessary in order to
    1. increase the relevancy of electronic patient portals.
    2. develop the most efficient programs.
    3. identify outcome measures associated with portal use.
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