A Qualitative Study of the Barriers and Opportunities for Adoption of Web-Portals for Doctors and Patients in Russia

The use of Web portals has several benefits. They have been proven to enhance communication between patients and health care professionals, allow patients to play a more active role in their own treatment and self-management, increase self-efficiency. Doctors can access patients‘ medical data and give recommendations to the patients. Some evidence of positive outcomes has been reported including improved clinical indicators and reduced health service use, as well as enhanced feelings of security and increased satisfaction with health and social care services. However, a number of studies have demonstrated that these types of solutions often fail to be successfully implemented and adopted within routine healthcare. The goal of the study was to analyze attitude of tuberculosis patients and doctors and identify perceived opportunities and barriers to operate a Web portal. The perceptions of 30 tuberculosis patients and 18 doctors (10 general practitioners and 8 phthisiatricians) from Tomsk, Russia were collected through semi-structured interviews. The responses were analyzed using grounded theory and thematic analysis, in order to understand the participants’ opinions and attitudes towards accepting tuberculosis web-portal in the treatment and rehabilitation process. We have recognized core topics that represented the participants’ responses. These core topics indicated that most respondents mentioned “the potential of tuberculosis web-portal to establish a better communication between doctors and patients” and “the increased health status of the patients” as the most valuable outcomes of adopting the tool. Both doctors and patients also expressed their opinions on the usability of the solutions, with no significant concerns reported about its usability. The main barrier we identified was different expectations of doctors and patients: doctors expected that the portal would decrease the amount of paper work and will help them to quickly react in acute cases, however, the patients were disappointed that the portal did not allow them to be able to reach doctors on the 24/7 basis and have a consultation whenever they felt they needed it. Finally, our findings disclosed that participants appreciated the perceived clinical utility of the portal, which could further have an influence on their intention to use it. The findings from our reported study in the area of tuberculosis treatment and rehabilitation suggested that the participants generally accepted the introduction of web-portal for the purpose of reporting health status and getting recommendation from the doctors as an alternative to the traditional doctor visits.

[1]  Yuying Zhang,et al.  A web-based intervention to support increased physical activity among at-risk adults , 2010, J. Biomed. Informatics.

[2]  Amy Clegg,et al.  Telemedicine in a Rural Community Hospital for Remote Wound Care Consultations , 2011, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[3]  Georgy Kopanitsa,et al.  Analysis of Metrics for the Usability Evaluation of Electronic Health Record Systems , 2012, EFMI-STC.

[4]  R. Parad,et al.  Evaluation of a web-based portal to improve resident education by neonatology fellows , 2014, Medical education online.

[5]  N. Pohontsch,et al.  Das kognitive Interview – Ein Instrument zur Entwicklung und Validierung von Erhebungsinstrumenten , 2015, Die Rehabilitation.

[6]  S. Leslie,et al.  Potential costs of B-type natriuretic peptide for the identification of people with heart failure in primary care in Scotland - a pilot study. , 2015, The journal of the Royal College of Physicians of Edinburgh.

[7]  Georgy Kopanitsa,et al.  Analysis of Metrics for the Usability Evaluation of EHR Management Systems , 2012, MIE.

[8]  Sisira Edirippulige,et al.  Telemedicine - A bibliometric and content analysis of 17, 932 publication records , 2014, Int. J. Medical Informatics.

[9]  Blackford Middleton,et al.  Design and implementation of a web-based patient portal linked to an ambulatory care electronic health record: patient gateway for diabetes collaborative care. , 2006, Diabetes technology & therapeutics.

[10]  Mohammad Iranmanesh,et al.  Determinants of Telemedicine Acceptance in Selected Public Hospitals in Malaysia: Clinical Perspective , 2014, Journal of Medical Systems.

[11]  B. Biggs,et al.  Telehealth: experience of the first 120 consultations delivered from a new Refugee Telehealth clinic , 2014, Internal medicine journal.

[12]  Chandan Chakraborty,et al.  Telemedicine Supported Chronic Wound Tissue Prediction Using Classification Approaches , 2016, Journal of Medical Systems.

[13]  Georgy Kopanitsa Development of a Web Portal Using Open Source Information Visualization Libraries. , 2016, Studies in health technology and informatics.

[14]  S. Nordfeldt,et al.  Consort-ehealth Checklist V1.6.2 Report Use of a Web 2.0 Portal to Improve Education and Communication in Paediatric Diabetes Patients with Families , 2022 .

[15]  Mattias Georgsson,et al.  Going Mobile With Diabetes Support: A Randomized Study of a Text Message–Based Personalized Behavioral Intervention for Type 2 Diabetes Self-Care , 2015, Diabetes Spectrum.

[16]  Georgy Kopanitsa,et al.  Implementation of a Clinical Decision Support System for Interpretation of Laboratory Tests for Patients , 2016, pHealth.

[17]  Brenda K. Wiederhold,et al.  mHealth Apps Empower Individuals , 2015, Cyberpsychology Behav. Soc. Netw..

[18]  Georgy Kopanitsa Evaluating study for a multiuser oriented medical data visualization method. , 2014, Studies in health technology and informatics.

[19]  J. Buchan Three approaches to safe staffing levels. , 2016, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[20]  Georgy Kopanitsa Evaluation study for a multi-user oriented medical data visualization method. , 2014, Studies in health technology and informatics.

[21]  Georgy Kopanitsa,et al.  Evaluation Study for an ISO 13606 Archetype Based Medical Data Visualization Method , 2015, Journal of Medical Systems.

[22]  T. Schweizer,et al.  Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation , 2014, Journal of medical Internet research.

[23]  Isao Nakajima Telehealth in the Pacific: Current Status and Analysis Report (1999–2000) , 2004, Journal of Medical Systems.

[24]  B. B. Zaidan,et al.  A Security Framework for Nationwide Health Information Exchange based on Telehealth Strategy , 2015, Journal of Medical Systems.

[25]  W. V. van Harten,et al.  An interactive portal to empower cancer survivors: a qualitative study on user expectations , 2015, Supportive Care in Cancer.

[26]  Measuring evidence-based practice knowledge and skills in occupational therapy—a brief instrument , 2015, BMC medical education.

[27]  M. Gilbert,et al.  Personal health records as portal to the electronic medical record , 2014, Journal of Neuro-Oncology.

[28]  T. Bjånes,et al.  A web portal for therapeutic drug monitoring. , 2015, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.

[29]  Maddalena Fiordelli,et al.  EMPOWER-support of patient empowerment by an intelligent self-management pathway for patients: study protocol , 2015, BMC Medical Informatics and Decision Making.

[30]  Charles Safran,et al.  Improving health care proxy documentation using a web-based interview through a patient portal , 2016, J. Am. Medical Informatics Assoc..

[31]  Sherry L Pagoto,et al.  A systematic review of electronic portal usage among patients with diabetes. , 2014, Diabetes technology & therapeutics.

[32]  Antoni Bayes-Genis,et al.  Evaluation of a telemedicine system for heart failure patients: feasibility, acceptance rate, satisfaction and changes in patient behavior: results from the CARME (CAtalan Remote Management Evaluation) study , 2012, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[33]  Stefan D Anker,et al.  Telemedicine and remote management of patients with heart failure , 2011, The Lancet.

[34]  Georgy Kopanitsa,et al.  Applying open source data visualization tools to standard based medical data. , 2014, Studies in health technology and informatics.

[35]  Georgy Kopanitsa Standard Based Multiclient Medical Data Visualization , 2012, MIE.

[36]  Sam Nordfeldt,et al.  To Use or Not to Use – Practitioners’ Perceptions of an Open Web Portal for Young Patients With Diabetes , 2012, Journal of medical Internet research.

[38]  J. Hendy,et al.  Experiences of front-line health professionals in the delivery of telehealth: a qualitative study. , 2014, The British journal of general practice : the journal of the Royal College of General Practitioners.

[39]  M. Shulgina,et al.  Tuberculosis in Russia. Its history and its status today. , 2015, American journal of respiratory and critical care medicine.

[40]  R. Merton,et al.  Thematic Analysis in Science: Notes on Holton's Concept. , 1975, Science.

[41]  Alexander Hörbst,et al.  Patient Empowerment by Electronic Health Records: First Results of a Systematic Review on the Benefit of Patient Portals , 2011, EFMI-STC.

[42]  Georgy Kopanitsa,et al.  Development, implementation and evaluation of an information model for archetype based user responsive medical data visualization , 2015, J. Biomed. Informatics.

[43]  N. Pohontsch,et al.  [Cognitive interviewing - a tool to develop and validate questionnaires]. , 2015, Die Rehabilitation.

[44]  C. Chapman,et al.  Qualitative research in healthcare: an introduction to grounded theory using thematic analysis. , 2015, The journal of the Royal College of Physicians of Edinburgh.

[45]  Chin-Feng Lin,et al.  Mobile Telemedicine: A Survey Study , 2012, Journal of Medical Systems.

[46]  Hans Demski,et al.  Standardized EHR interoperability - preliminary results of a German pilot project using the archetype methodology. , 2012, Studies in health technology and informatics.

[47]  Kerina H. Jones,et al.  The feasibility of collecting information from people with Multiple Sclerosis for the UK MS Register via a web portal: characterising a cohort of people with MS , 2012, BMC Medical Informatics and Decision Making.

[48]  Stuart M Speedie,et al.  Perception, satisfaction and utilization of the VALUE home telehealth service , 2011, Journal of telemedicine and telecare.

[49]  Claudia Hildebrand,et al.  EMPOWER - Pathways for Supporting the Self-management of Diabetes Patients , 2015, eHealth.

[50]  Jennifer L. Lovell How parents process child health and nutrition information: A grounded theory model , 2016, Appetite.

[51]  G. Rutten,et al.  Patients’ Experiences with and Attitudes towards a Diabetes Patient Web Portal , 2015, PloS one.

[52]  K H Englmeier,et al.  Visualization of Medical Data Based on EHR Standards , 2012, Methods of Information in Medicine.