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Framework for Evaluating and Implementing Inpatient Portals: a Multi-stakeholder Perspective

  • Patient Facing Systems
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Abstract

Inpatient portals are emerging as an important tool to support patient care and are increasingly being adopted in hospitals. However, best practices concerning the implementation, use, and impact of these portals are poorly understood. To improve evaluation and implementation efforts, this paper develops a logic model that can help researchers and hospital managers in deploying and assessing the impact of inpatient portals. Guided by the Systems Engineering Initiative for Patient Safety (SEIPS) framework, we held a series of two focus groups (n = 12 and n = 8, respectively) and an online forum (n = 14) including hospital administrators, clinicians, patients, and information technology team members to learn from these stakeholders about the system-wide implementation and evaluation of an inpatient portal at an academic medical center in the United States. These sessions were supplemented with a Nominal Group process to assess the relative importance and feasibility of evaluation areas. Our Logic Model highlights that patients are at the center of the multi-stakeholder context within which inpatient portals are being implemented, and that collaborative work is necessary for successful implementation and evaluation of the tool. The Model also identifies priority areas for evaluation, and it suggests measures and data sources applicable for quality improvement and research. Applying the SEIPS 2.0 framework, this Logic Model captures the multiple relevant stakeholder perspectives by describing the organizational structures, processes, and outcomes that pertain to inpatient portals. This Model provides specific evaluation suggestions for hospital managers seeking to implement inpatient portals as well as for researchers seeking to evaluate this new technology.

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Acknowledgements

The authors wish to thank Lindsey Sova, Alice Gaughan, Terri Menser, Danijela Cvijetinovic, Toby Weinert, Jaclyn Volney, and Caitlin Slevin, all affiliated with the author’s organization at the time of the study, for their assistance with this project. We are also grateful to our study participants.

Funding

This work was supported by the Agency for Healthcare Research and Quality (AHRQ) Grants R01 HS024091–01 and R21 HS024349–01 as well as P30-HS024379 through The Ohio State University Institute for the Design of Environments Aligned For Patient Safety (IDEA4PS). While this research was funded by the Agency for Healthcare Research and Quality, 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.

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Authors and Affiliations

  1. Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA

    Daniel M. Walker, Jennifer L. Hefner, Cynthia J. Sieck, Timothy R. Huerta & Ann Scheck McAlearney

  2. CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking, Ohio State University College of Medicine, 460 Medical Center Drive, Ste. 530, Columbus, OH, 43210, USA

    Daniel M. Walker, Jennifer L. Hefner, Cynthia J. Sieck, Timothy R. Huerta & Ann Scheck McAlearney

  3. Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA

    Daniel M. Walker, Timothy R. Huerta & Ann Scheck McAlearney

  4. Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA

    Timothy R. Huerta & Ann Scheck McAlearney

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  1. Daniel M. Walker
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Correspondence to Ann Scheck McAlearney.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Ohio State University Institutional Review Board approved all study activities, and informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Walker, D.M., Hefner, J.L., Sieck, C.J. et al. Framework for Evaluating and Implementing Inpatient Portals: a Multi-stakeholder Perspective. J Med Syst 42, 158 (2018). https://doi.org/10.1007/s10916-018-1009-3

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