Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2017 Health Portal Functionality and the Use of Patient- Centered Technology Anita Joyce Simmons Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Databases and Information Systems Commons, Nursing Commons, and the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral study by Anita Simmons has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Joan Moon, Committee Chairperson, Health Services Faculty Dr. Susan Hayden, Committee Member, Health Services Faculty Dr. Patricia Schweickert, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2016 Abstract Health Portal Functionality and the Use of Patient-Centered Technology by Anita Joyce Simmons MSN, Harding University, 2004 BSN, Harding University, 1987 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2016 Abstract Health portals are dedicated web pages for medical practices to provide patients access to their electronic health records. The problem identified in this quality improvement project was that the health portal in the urgent care setting had not been available to staff nor patients. To provide leadership with information related to opening the portal, the first purpose of the project was to assess staff and patients’ perceived use, ease of use, attitude toward using, and intention to use the portal. The second purpose was to evaluate the portal education materials for the top 5 urgent care diagnoses: diabetes, hypertension, asthma, otitis media, and bronchitis for understandability and actionability using the Patient Education Material Assessment Tool, Simple Measures of Goobledygook, and the Up to Date application. The first purpose was framed within the technology acceptance model which used a 26-item Likert scale ranging from -3 (total disagreement) to +3 (total agreement). The staff (n = 8) and patients ( n = 75) perceived the portal as useful (62%; 60%), easy to use (72%; 70%), expressed a positive attitude toward using (71%; 73%), and would use the technology (54%; 70%). All materials were deemed understandable (74%-95%) with 70% being the acceptable percentage. Diabetes, otitis media, and bronchitis were deemed actionable (71-100%), but hypertension (57%) and asthma (40%) had lower actionability percentages. Hypertension, asthma, and otitis media had appropriate reading levels (6-8th grade). However, diabetes (10th grade) and bronchitis (12 th grade) were higher with the target being less than 8 th grade level. All handouts were found to be evidence-based. Recommendations were to revise the diabetes and bronchitis educational handouts to improve readability. Social change can be promoted by this project by facilitating positive patient outcomes at urgent care clinics. Health Portal Functionality and the Use of Patient-Centered Technology by Anita Joyce Simmons MSN, Harding University, 2004 BSN, Harding University, 1987 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2016 Dedication I would like to dedicate this project to my mother and father. They always wanted me to continue to pursue my dreams. Thanks for pushing me to do so. Secondly, I would like to dedicate this to all my coworkers who work with electronic health records every day. Proud that we were the first ones to promote their use and have seen them significantly impact our nursing practice and improve our patient’s quality of life. Acknowledgements I would like to thank Dr. Joan Moon for her patience, direction, and encouragement throughout the DNP process. Her support and recommendations were paramount to the final project. I can never repay her for spending quality time at all hours of the day and night and for her encouragement. I would also like to thank one of my committee members Dr. Hayden for her multiple reviews of my project paper and for helping me clearly focus on the topic. In addition, I would like to include Dr. Schweickert and Jenny Martel for guidance on this fruitful journey. I would like to thank my daughters, Rebecca and Rachel, whom have shown resounding support throughout the journey. Thank you for understanding my passion. I hope this experience has encouraged you both to always go for your dreams no matter how many classes you have to take to get there. You all will graduate soon and I could not be more proud of what you have accomplished so far. Keep the educational embers burning. Also, to my dear husband, who has been my rock and gave me encouragement every day to keep pursuing my dream. I am very grateful for many hours of conversation about health portals and the educational needs of my patients. I appreciate you humoring me and becoming engaged in a topic that you knew nothing about. I could not have completed the project without your help. Table of Contents Section 1: Overview of Evidence-Based Project .................................................................1 Introduction ....................................................................................................................1 Background ....................................................................................................................4 Problem Statement .........................................................................................................5 Purpose ...........................................................................................................................6 DNP Project Questions ..................................................................................................6 Framework .....................................................................................................................7 Nature of the Project ......................................................................................................8 Definitions of Terms ......................................................................................................9 Assumptions .................................................................................................................12 Limitations ...................................................................................................................12 Significance of the Project ...........................................................................................13 Summary ......................................................................................................................14 Section 2: Review of Scholarly Literature .........................................................................15 Introduction ..................................................................................................................15 Literature Search Strategy............................................................................................16 Literature Review.........................................................................................................16 Summary ......................................................................................................................30 Section 3: Approach and Methods .....................................................................................31 Introduction ..................................................................................................................31 Approach and Rationale ...............................................................................................31 Technology Acceptance Model ...................................................................................32 Population ....................................................................................................................32 Ethical Protection of Participants.................................................................................33 Data Collection for the TAM Questionnaire ...............................................................34 Technology Acceptance Model Instruments ...............................................................35 Data Analysis of the TAM Questionnaires ..................................................................36 Evaluation of the TAM Questionnaire .........................................................................36 Assessment of Educational Materials Related to Evidence and Literacy ....................37 Summary ......................................................................................................................42 Section 4: Findings, Discussion, and Implications ............................................................43 Introduction ..................................................................................................................43 Evaluation, Findings, and Discussion ..........................................................................43