The Use of Clinical Systems to Improve Outcomes and Efficiencies Diabetes Management

Literature Review
The Use of Clinical Systems to Improve Outcomes and Efficiencies: Special Focus on Patient Portals in Diabetes Management
Patient portals come in handy in seeking to promote the access that patents have to their personal healthcare data. Of relevance on this front could be patient lab results, doctor notes, prescriptions, billing, the relevant information regarding the next appointment, etc. It is also important to note that in some instances, patient portals do permit patients to actively communicate with their healthcare providers. Thus, from a general perspective, patient portals could be described as online tools designed to promote the health and wellbeing of patients by offering patients access to their personal health information (Sun, Korytkowski, Sereike, Saul, Li, and Burke, 2018). In essence, there is need for a reliable internet connection for patent portals to function as intended. At present, patient portals continue to be widely utilized by healthcare providers. In this case, patents are permitted to set up an account which is secured using a password so as to ensure that only the patient in this case has access to their health information.
According to, Dendere, Sade, Burton-Jones, Sllivan, Staib, and Janda (2019), one of the most effective ways of improving patient satisfaction as well as health outcomes is via the constant engagement of the said patients in the course of healthcare delivery. In that regard, therefore, the authors point out that “patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication” (Dendere, Sade, Burton-Jones, Sllivan, Staib, and Janda, 2019, p. 61).
Owing to the increased implementation of patent portals and the benefits of the same on various fronts, as has been highlighted in various research studies, it would be prudent to evaluate the utilization of patient portals in the management of diabetes. Sun, Korytkowski, Sereike, Saul, Li, and Burke (2018) observe that there is need for constant collaborative efforts between providers and diabetes patients in as far as the effective management of diabetes and other chronic diseases is concerned. However, the authors regret that as presently structured, most healthcare systems are not fully supportive of the various needs of patients with chronic conditions. It is on the basis of this reality that healthcare institutions ought to be called upon to further embrace patient portals which, as has been demonstrated in this text, could come in handy in diabetes management.
Of all chronic diseases, diabetes happens to be the most debilitating. It that regard, therefore, it is important to note that in seeking to minimize the risks associated with diabetes, the relevance of the effective management of the same cannot be overstated. Some of the risks of poor management of this particular chronic disease include, but they are not limited to kidney failure and health disease. Advances in healthcare in recent times have indicated that patent engagement as well as support are two of the most important considerations when it comes to the effective management of diabetes. According to Jackson, DesRoaches, Frosch, Peacock, Oster, and Elmore (2018), patient portals further expand the possibilities in as far as ensuring that patients have adequate tools as well as support to manage the chronic condition is concerned. This is particularly the case with the advent of the internet. At present, there is sufficient evidence to indicate that as far as the management of diabetes is concerned, patient portals have the capability of further improving diabetes patients’ health indicators (Jackson, DesRoaches, Frosch, Peacock, Oster, and Elmore, 2018). This is more so the case when it comes to not only the active engagement of the said patients in proper diabetes management activities and undertakings, but also increased access to the relevant information on the chronic disease.
Several studies have documented the relevance of patient portals in as far as the outcomes and efficiencies within the healthcare delivery as well as nursing practice contexts are concerned. To begin with, patient portals, according to Sun, Korytkowski, Sereike, Saul, Li, and Burke, (2018) motivate behavior change and promote self-efficacy. For instance, the awareness of patients with regard to the control of their diabetes is stronger when the patient portal presents the relevant metrics, i.e. with regard to weight value and historical blood sugar. This is more so the case if the information in this case is presented using visual tools and instruments such as graphs that clearly demonstrate trends. In essence, this could prompt patients who feel they are not managing the condition well to make the relevant adjustments in a few critical areas such as the exercise regimen or diet. In that regard, therefore, when it come to the management of diabetes, the patient portal could be seen as motivation source. As Dendere, Sade, Burton-Jones, Sllivan, Staib, and Janda (2019) observe, there is sufficient evidence to indicate that patient portals further promote adherence to medications. As a matter of fact, the authors are convinced that this particular reason, alongside the further enhancement of patient engagement, explains the increased implementation of patient portals by most healthcare organizations.
Next, closely related to the first point above is patient awareness regarding their diabetes. It is important to note that patients are more likely to be self-aware if they can easily access their health data in formats that are easy to understand (Sun, Korytkowski, Sereike, Saul, Li, and Burke, 2018). This is particularly the case when it comes to the utilization of the relevant visual tools to display various metrics.
Third, it should also be noted that in the management of diabetes, patient portals come in handy as key information sources (Jackson, DesRoaches, Frosch, Peacock, Oster, and Elmore, 2018). This is more so the case in those instances where the said portals incorporate a health library that highlights key facts about diabetes and effective management of the same, i.e. in relation to exercises, diet, and other key lifestyle considerations. Further, information about the side effects of poor management of the condition as well as co-morbidities could be incorporated herein so as to ensure that patients embrace good diabetes management practices. When such information is presented to patients in easily understandable formats, then such patients are likely to benefit by way of better controlling their sugar levels. Thanks to the involvement of healthcare professionals, the information that patients are likely to access via the patient portal is of higher quality than that which they could find via a generic search engine such as Google. As Jackson, DesRoaches, Frosch, Peacock, Oster, and Elmore (2018) point out, doctor notes are of special relevance in the effective management of diabetes. In their own words, the authors are of the opinion that “patients with chronic diseases such as diabetes might receive an even greater benefit from access to their doctors' notes than the general patient population” (Jackson, DesRoaches, Frosch, Peacock, Oster, and Elmore, 2018, p. 957).
Regardless of the efforts to implement patient portals in the management of diabetes and the available evidence indicating that patient portals do indeed result in better outcomes on this front, it should be noted that there are barriers to the adoption of the same that ought to be identified. One such barrier in this case would be long-term adherence. This is more so the case given that following the initial constant utilization of the portal, patients could feel that they now possess the relevant skills in self-management without the active utilization of the portal. Poor ongoing support could also discourage long-term utilization of the portal. It is for this reason that Jackson, DesRoaches, Frosch, Peacock, Oster, and Elmore (2018) point out that there is need for doctors and other healthcare professionals to routinely encourage diabetes patients to utilize portals. This is more so the case given that in their study seeking to establish the opinion of diabetes care providers on patient portals, Ronda, Dijkhorst-Oei, Vos, and Rutten (2018) found out that “providers are positive about patients web portals but still not recommend or encourage the use to all patients” (80).
There is also the issue of usability. Amante, Hogan, Pagoto, and English (2014) brand this phenomenon as “negative patient experiences using portals” (115). If the patient portal is difficult to navigate, patients are not likely to use of the portal in the long-term. Thus, the interface ought to be made as easy to navigate as is possible so as to promote constant patient-portal interactions.
In seeking to promote long-term adherence – which is one of the barriers to the effective utilization of patient portals that have been identified in this text – there may be need to ensure that patient portals contain personalized content. Further, the portal could be established in such a way that it permits regular follow-up that is largely automatic. The relevance of promoting the usability of the portal cannot also be overstated. This is particularly the case when it comes to ensuring that users find it easy to enter data and navigate the portal.
Measures may also have to be put in place to ensure that the features of the patient portal offers are actively utilized by patients. This could be done by way of educating patients, from time to time, on specific portal functionalities. An online tutorial could come in handy in this endeavor.
References
Amante, D.J., Hogan, T.P., Pagoto, S.L. & English, T.M. (2014). A Systematic Review of Electronic Portal Usage among Patients with Diabetes. Diabetes Technology & Therapeutics, 16(11), 112-118.
Jackson, S.L., DesRoaches, C.M., Frosch, D.L., Peacock, S., Oster, N.V. & Elmore, J.G. (2018). Will Use of Patient Portals Help to Educate and Communicate With Patients With Diabetes? Patient Educ Couns., 101(5), 956-959.
Ronda, M.C., Dijkhorst-Oei, L., Vos, R.C. & Rutten, G.E. (2018). Diabetes Care Providers’ Opinions and Working Methods after Four Years of Experience with a Diabetes Patient Web Portal; A Survey among Health Care Providers in General Practices and an Outpatient Clinic. BMC Family Practice, 19(94), 79-84.
Sun, R., Korytkowski, M.T., Sereike, S.M., Saul, M.L., Li, D. & Burke, L.E. (2018). Patient Portal Use in Diabetes Management: Literature Review. JMIR Diabetes, 3(4), 41-48.
Dendere, R., Sade, C., Burton-Jones, A., Sullivan, C., Staib, A. & Janda, M. (2019). Patient Portals Facilitating Engagement with Inpatient Electronic Medical Records: A Systematic Review. J Med Internet Res, 21(4), 60-66.