Why are Patient Portals Important in the Age of COVID-19? Reflecting on Patient and Team Experiences From a Toronto Hospital Network.

The COVID-19 pandemic has changed how care is being delivered in Canada. With conventional in-person care being transitioned to virtual care, the approach that patients are able to engage and access their care has dramatically changed. At the University Health Network (UHN), which is Canada's largest academic and teaching hospital network, we expanded the myUHN Patient Portal in 2017 after its early adopter phase to enable patients and family members to view parts of their clinical notes and test results. As the pandemic progressed, we observed high adoption of myUHN to support virtual care and rapid delivery of COVID-19 test results in real time. In this article, we share and reflect on our experience of adapting myUHN to support the demands of the pandemic, including portal adoption outcomes across multiple waves of the pandemic, the impetus for increased patient experience staff dedicated for myUHN support, and patients' perceptions of the value of the portal and virtual care. Based on these reflections, we outline our perspectives on the future role of patient portals to support patient care and experience in a post-pandemic environment.

Exploring the value of using patient-oriented MRI reports in clinical practice - a pilot study.

PURPOSE: Standard radiology reports (SRR) are designed to communicate information between doctors. With many patients having instantaneous access to SRRs on patient portals, interpretation without guidance from doctors can cause anxiety and panic. In this pilot study, we designed a patient-centred prostate MRI template report (PACERR) to address some of these challenges and tested whether PACERRs improve patient knowledge and experience. MATERIALS AND METHODS: Patients booked for clinical prostate MRI were randomly assigned to SRR or SRR + PACERR. Questionnaires included multiple-choice that targeted 4 domains (understanding, usefulness, next steps, emotional experience) hypothesized to improve with patient-centred reports and short answer questions, testing knowledge regarding MRI results. Clinical encounters were observed and recorded to explore whether adding PACERR improved communication. Likert scaled-responses and short-answer questions were compared using Mann-Whitney U test and Kruskal-Wallis test. RESULTS: Of the 40 participants, the majority were MRI naïve (70%). Patients receiving a PACERR had higher scores in the categories of patient understanding (mean: 4.17 vs. 3.39, p=0.006), usefulness (mean: 4.58 vs. 3.07, p<0.001), and identifying next steps (mean: 1.89 vs. 3.03, p=0.003) but not emotional experience (mean: 4.18 vs. 3.79, p=0.22). PACERR participants found the layout and design more patient friendly (mean: 4.47 vs. 2.61, p<0.001) and easier to understand (mean: 4.37 vs. 2.38, p<0.001). In the knowledge section, overall, the PACERR arm scored better (87% vs. 56%, p=0.004). CONCLUSION: With the addition of prostate MRI PACERR, participants had better understanding of their results and felt more prepared to involve themselves in discussions with their doctor.

Creating patient-centered radiology reports to empower patients undergoing prostate magnetic resonance imaging.

INTRODUCTION: As we progress to an era when patient autonomy and shared decision-making are highly valued, there is a need to also have effective patient-centered communication tools. Radiology reports are designed for clinicians and can be very technical and difficult for patients to understand. It is important for patients to understand their magnetic resonance imaging (MRI) report in order to make an informed treatment decision with their physician. Therefore, we aimed to create a patient-centered prostate MRI report to give our patients a better understanding of their clinical condition. METHODS: A prototype patient-centered radiology report (PACERR) was created by identifying items to include based on opinions sought from a group of patients undergoing prostate MRI and medical experts. Data was collected in semi-structured interviews using a salient belief question. A prototype PACERR was created in collaboration with human factors engineering and design, medical imaging, biomedical informatics, and cancer patient education groups. RESULTS: Fifteen patients and eight experts from urology, radiation oncology, radiology, and nursing participated in this study. Patients were particularly interested to have a report with laymen terms, concise language, contextualization of values, definitions of medical terms, and next course of action. Everyone believed the report should include the risk of MRI findings actually being cancer in the subsequent biopsy. CONCLUSIONS: A prostate MRI PACERR has been developed to communicate the most important findings relevant to decision-making in prostate cancer using patient-oriented design principles. The ability of this tool to improve patient knowledge and communication will be explored.

Adoption Strategies for Electronic Patient Portals: Employing Advanced Data Mining and Analytics.

Patient portals are becoming increasingly available at medical institutions, worldwide. Reporting of patient portal adoption strategies is scarce. A multi-institutional health network in Toronto, Canada is seeing great success with its portal adoption by patients, with an annual adoption rate of almost 65%. In the literature, annually adoption rates in Canada range between 5% and 10%. This significant difference and high adoption is attributed to a multifactorial approach that includes a dedicated operations team to engage with patients and staff, a co-design approach for portal development and more recently, new data-driven strategies to affirm and recommend promotion approaches. Advanced data mining and analytics are promising tools to help improve the adoption rate. This paper will describe five analytics tools used to describe and potentially improve patient portal adoption rates.

Patient relations "road show" at university health network.

COMPLAINTS, COMPLAINTS, COMPLAINTS! Where are my results? Why do I have to wait so long? Is anybody listening? Does anybody care? I'm a taxpayer; I am entitled! Sound familiar? These are the kinds of things we hear on a daily basis from patients and family members.

Ombudsman for a day: a job rotation opportunity at the University Health Network.

When staff at a major Canadian teaching hospital were asked what they found meaningful and important in the working environment, they responded by identifying four specific areas: recognition, communication, workload management and learning environment. One area that was identified as a particularly good example of a successful "learning environment" strategy was the opportunity to participate in a job rotation in a department other than their own.