ArticleJournal of the American Medical Informatics Association : JAMIA2017
Meaningful use in the safety net: a rapid ethnography of patient portal implementation at five community health centers in California.
Article in Journal of the American Medical Informatics Association : JAMIA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Quantifying Patient Portal Use: Systematic Review of Utilization Metrics.Journal of medical Internet research · 2021Pooled it
- Using Electronic Health Record Portals to Improve Patient Engagement: Research Priorities and Best Practices.Annals of internal medicine · 2020Pooled it
- Operationalizing rapid implementation science for responsive HIV programs.Frontiers in health services · 2026Article
- Automatic Enrollment in Patient Portal Systems Mitigates the Digital Divide in Healthcare: An Interrupted Time Series Analysis of an Autoenrollment Workflow Intervention.Journal of medical systems · 2024Article
- System-Level Factors and Time Spent on Electronic Health Records by Primary Care Physicians.JAMA network open · 2023Article
- Perspectives From Community-Based HIV Service Organization Leaders on Priorities in Serving Sexual and Gender Minority Populations.AIDS education and prevention : official publication of the International Society for AIDS Education · 2023Article
- Article
- Barriers to family history collection among Spanish-speaking primary care patients: a BRIDGE qualitative study.PEC innovation · 2022Article
- Chinese Americans' Use of Patient Portal Systems: Scoping Review.JMIR human factors · 2022Article
- A mixed methods analysis of environmental and household chaos: considerations for early-childhood obesity research.BMC public health · 2021Article
- UNICEF UK Baby Friendly Initiative: Providing, receiving and leading infant feeding care in a hospital maternity setting-A critical ethnography.Maternal & child nutrition · 2021Article
- Growth of Ambulatory Virtual Visits and Differential Use by Patient Sociodemographics at One Urban Academic Medical Center During the COVID-19 Pandemic: Retrospective Analysis.JMIR medical informatics · 2020Article
- Design of a cluster-randomized trial of the effectiveness and cost-effectiveness of metformin on prevention of type 2 diabetes among prediabetic Mexican adults (the PRuDENTE initiative of Mexico City).Contemporary clinical trials · 2020Article
- Implementation Science to Respond to the COVID-19 Pandemic.Frontiers in public health · 2020Article
- Using Patient and Family Engagement Strategies to Improve Outcomes of Health Information Technology Initiatives: Scoping Review.Journal of medical Internet research · 2019Article
- Providing Access: Differences in Pediatric Portal Activation Begin at Patient Check-in.Applied clinical informatics · 2019Article
- Is research on patient portals attuned to health equity? A scoping review.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Innovations in Mixed Methods Evaluations.Annual review of public health · 2019Review
- Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) in Pragmatic Clinical Trials of Mental Health Services Implementation: Methods and Applied Case Study.Administration and policy in mental health · 2019Article
- Mobile Phone, Computer, and Internet Use Among Older Homeless Adults: Results from the HOPE HOME Cohort Study.JMIR mHealth and uHealth · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectiveUS health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. MATERIALS AND
methodsOur rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n = 12), informal focus groups with front-line staff ( n = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n = 45).
resultsOur findings demonstrate that the health systems devoted considerable effort to enlisting staff support for portal adoption and integrating portal-related work into clinic routines. Although all health systems had achieved, or were close to achieving, MU benchmarks, patients faced numerous barriers to portal use and our participants were uncertain how to achieve and sustain "meaningful use" as defined by and for their patients. DISCUSSION: Health systems' efforts to achieve MU certification united clinic staff under a shared ethos of improved quality of care. However, MU's assumptions about patients' demand for electronic access to health information and ability to make use of it directed clinics' attention to enrollment and message routing rather than to the relevance and usability of a tool that is minimally adaptable to the safety net context.
conclusionWe found a mismatch between MU-based metrics of patient engagement and the priorities and needs of safety net patient populations.
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