@文章{信息:doi/10.2196/11350，作者=“Abel, Erica A和Shimada, Stephanie L和Wang, Karen和Ramsey, Christine和Skanderson, Melissa和Erdos, Joseph和Godleski, Linda和Houston, Thomas K和Brandt, Cynthia A”，标题=“退伍军人精神健康诊断患者门户和临床视频远程医疗的双重使用:回顾性，横断面分析”，期刊=“J Med Internet Res”，年=“2018”，月=“11”，日=“07”，卷=“20”，数=“11”，页数=“e11350”，关键词=“心理健康”;病人门户;远程医疗;远程医疗;电子健康;美国退伍军人事务部"，摘要="背景:获得精神卫生保健具有挑战性。退伍军人健康管理局(VHA)一直在通过技术创新解决这些挑战，包括实施临床视频远程医疗，提供者和患者之间的双向互动和同步视频会议，以及电子患者门户和个人健康记录，My HealtheVet。目的:本研究旨在描述心理健康诊断的VHA用户早期采用和使用My HealtheVet和临床视频远程医疗。方法:我们对2007年至2012年在VHA用户中有一项或多项精神健康诊断的退伍军人早期采用My HealtheVet和临床视频远程医疗参与进行了回顾性横断面分析。 We categorized veterans into four electronic health (eHealth) technology use groups: My HealtheVet only, Clinical Video Telehealth only, dual users who used both, and nonusers of either. We examined demographic characteristics and mental health diagnoses by group. We explored My HealtheVet feature use among My HealtheVet adopters. We then explored predictors of My HealtheVet adoption, Clinical Video Telehealth engagement, and dual use using multivariate logistic regression. Results: Among 2.17 million veterans with one or more mental health diagnoses, 1.51{\%} (32,723/2,171,325) were dual users, and 71.72{\%} (1,557,218/2,171,325) were nonusers of both My HealtheVet and Clinical Video Telehealth. African American and Latino patients were significantly less likely to engage in Clinical Video Telehealth or use My HealtheVet compared with white patients. Low-income patients who met the criteria for free care were significantly less likely to be My HealtheVet or dual users than those who did not. The odds of Clinical Video Telehealth engagement and dual use decreased with increasing age. Women were more likely than men to be My HealtheVet or dual users but less likely than men to be Clinical Video Telehealth users. Patients with schizophrenia or schizoaffective disorder were significantly less likely to be My HealtheVet or dual users than those with other mental health diagnoses (odds ratio, OR 0.50, CI 0.47-0.53 and OR 0.75, CI 0.69-0.80, respectively). Dual users were younger (53.08 years, SD 13.7, vs 60.11 years, SD 15.83), more likely to be white, and less likely to be low-income than the overall cohort. Although rural patients had 17{\%} lower odds of My HealtheVet adoption compared with urban patients (OR 0.83, 95{\%} CI 0.80-0.87), they were substantially more likely than their urban counterparts to engage in Clinical Video Telehealth and dual use (OR 2.45, 95{\%} CI 1.95-3.09 for Clinical Video Telehealth and OR 2.11, 95{\%} CI 1.81-2.47 for dual use). Conclusions: During this study (2007-2012), use of these technologies was low, leaving much potential for growth. There were sociodemographic disparities in access to My HealtheVet and Clinical Video Telehealth and in dual use of these technologies. There was also variation based on types of mental health diagnosis. More research is needed to ensure that these and other patient-facing eHealth technologies are accessible and effectively used by all vulnerable patients. ", issn="1438-8871", doi="10.2196/11350", url="//www.mybigtv.com/2018/11/e11350/", url="https://doi.org/10.2196/11350", url="http://www.ncbi.nlm.nih.gov/pubmed/30404771" }