title: Healthcare Team Perceptions of a Portal for Parents of Hospitalized Children Before and After Implementation.
abstract: Patient electronic health record (EHR) portals can enhance patient and family engagement by providing information and a way to communicate with their healthcare team (HCT). However, portal implementation has been limited to ambulatory settings and met with resistance from HCTs.
  
  
  
  We evaluated HCT perceptions before and 6-months after implementation of an inpatient EHR portal application on a tablet computer given to parents of hospitalized children.
  
  
  
  This repeated cross-sectional study was conducted with HCT members (nurses, physicians, ancillary staff) on a medical/surgical unit at a quaternary children's hospital. From December 2014-June 2015, parents of children <12 years old were given a portal application on a tablet computer. It provided real-time vitals, medications, lab results, schedules, education, HCT information and a way to send the HCT messages/requests. HCT members completed surveys pre- and post-implementation regarding their portal perceptions. Pre-post differences in HCT perceptions were compared using chi-squared, Mann-Whitney and Kruskall Wallis tests.
  
  
  
  Pre-implementation, HCT respondents (N=94) were generally optimistic about the benefits of a portal for parents; however, all anticipated challenges to portal use. Over the next 6-months, 296 parents used the portal, sending 176 requests and 36 messages. Post-implementation, HCT respondent (N=70) perceptions of these challenges were significantly reduced (all p<0.001), including: parents (will) have too many questions (69 vs. 3%, pre-post), parents (will) know results before the HCT (65 vs. 1%), staff (would be/are) skeptical (43 vs. 21%) and there (will be/is) not enough technical support (28 vs. 1%).
  
  
  
  All HCT respondents anticipated challenges in providing a portal to parents of hospitalized children; however, these concerns were minimized after implementation.
authors.affiliation: Michelle M. Kelly, MD, H4/419 CSC, 600 Highland Ave., Madison, WI 53792, USA, Phone: (608) 265-5545, Fax: (608) 265-8074, Email: michelle.kelly@wisc.edu.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Kelly
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Dean
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
authors.forename: Tosha B
authors.initials: TB
authors.lastname: Wetterneck
authors.forename: Peter L T
authors.initials: PL
authors.lastname: Hoonakker
mesh_terms: D002648:Child; D057286:Electronic Health Records; D006760:Hospitalization; D006801:Humans; D010290:Parents; D010348:Patient Care Team / Q000706:statistics & numerical data*; D000072638:Patient Portals / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Inpatient; and personal health record; engagement; health information technology; pediatrics