Download PDF
Appl Clin Inform 2019; 10(05): 898-908
DOI: 10.1055/s-0039-1700867
AMIA CIC 2019
Georg Thieme Verlag KG Stuttgart · New York

Facilitating Organizational Change to Accommodate an Inpatient Portal

Daniel M. Walker
1   Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
2   Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
3   Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
4   Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, United States
,
Alice Gaughan
2   Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Naleef Fareed
2   Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
3   Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Susan Moffatt-Bruce
2   Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
3   Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
5   Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Ann Scheck McAlearney
1   Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
2   Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States
3   Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
4   Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, United States
› Author Affiliations Funding This work was supported by the Agency for Healthcare Research and Quality (AHRQ) grants R01HS024091, R21HS024767, and P30HS024379. While this research was funded by AHRQ, the study sponsor had no involvement in the collection, analysis, or interpretation of data; in the writing of this manuscript; or in the decision to submit the manuscript for publication.
Further Information

Publication History

05 August 2019

18 September 2019

Publication Date:
27 November 2019 (online)

Also available at
   Permissions and Reprints
Zoom Image

Abstract

Background Patient portals are becoming more commonly used in the hospital inpatient setting. While the potential benefits of inpatient portals are acknowledged, there is a need for research that examines the challenges of portal implementation and the development of best practice approaches for successful implementation.

Objective We conducted this study to improve our understanding of the impact of the implementation of an inpatient portal on care team members in the context of a large academic medical center. Our study focused on the perspectives of nursing care team members about the inpatient portal.

Methods We interviewed care team members (n = 437) in four phases throughout the 2 years following implementation of an inpatient portal to learn about their ongoing perspectives regarding the inpatient portal and its impact on the organization.

Results The perspectives of care team members demonstrated a change in acceptance of the inpatient portal over time in terms of buy-in, positive workflow changes, and acknowledged benefits of the portal for both care team members and patients. There were also changes over time in perspectives of the care team in regards to (1) challenges with new technology, (2) impact of the portal on workflow, and (3) buy-in. Six strategies were identified as important for implementation success: (1) convene a stakeholder group, (2) offer continual portal training, (3) encourage shared responsibility, (4) identify champions, (5) provide provisioning feedback, and (6) support patient use.

Conclusion Inpatient portals are recognized as an important tool for both patients and care team members, but the implementation of such a technology can create challenges. Given the perspectives care team members had about the impact of the inpatient portal, our findings suggest implementation requires attention to organizational changes that are needed to accommodate the tool and the development of strategies that can address challenges associated with the portal.

Keywords

patient portals - implementation - organizational culture - hospitalization - nursing informatics - engagement - organizational change

Protection of Human and Anmial Subject

Conduct of this research was reviewed and approved by The Ohio State University Institutional Review Board.