@文章{信息:doi/10.2196/21385，作者=“Portz, Jennifer D和Brungardt, Adreanne和Shanbhag, Prajakta和Staton, Elizabeth W和Bose-Brill, Seuli和Lin，陈tan和Kutner, Jean S和Lum, Hillary D”，标题=“COVID-19大流行期间患者门户网站用户的提前护理计划:回顾性观察研究”，期刊=“J医学互联网研究”，年=“2020”，月=“8”，日=“11”，卷=“22”，数=“8”，页=“e21385”，关键词=“提前护理计划;电子健康记录;大流行;COVID-19;预先指令;病人门户;规划;基于web的工具;背景:预先护理计划是根据患者的个人价值观讨论医疗保健治疗偏好的过程，通常涉及预先指示的完成。在2020年的头几个月，一种新型冠状病毒，严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)开始在美国科罗拉多州广泛传播，导致冠状病毒病(COVID-19)的广泛诊断、住院和死亡。 In this context, the importance of technology-based, non--face-to-face methods to conduct advance care planning via patient portals has increased. Objective: The aim of this study was to determine the rates of use of a web-based advance care planning tool through a health system--based electronic patient portal both before and in the early months of the COVID-19 pandemic. Methods: In 2017, we implemented web-based tools through the patient portal of UCHealth's electronic health record (EHR) for patients to learn about advance care planning and complete an electronically signed medical durable power of attorney (MDPOA) to legally appoint a medical decision maker. Patients accessing the portal can complete and submit a legally valid MDPOA, which becomes part of their medical record. We collected data on the patients' date of MDPOA completion, use of advance care planning messaging, age, sex, and geographic location during the early phase of the COVID-19 pandemic (December 29, 2019, to May 30, 2020). Results: Over a 5-month period that includes the early phase of the COVID-19 pandemic in Colorado, total monthly use of the advance care planning portal tool increased from 418 users in January to 1037 users in April and then decreased slightly to 815 users in May. The number of MDPOA forms submitted per week increased 2.4-fold after the stay-at-home order was issued in Colorado on March 26, 2020 (P<.001). The mean age of the advance care planning portal users was 47.7 years (SD 16.1), and 2206/3292 (67.0{\%}) were female. Women were more likely than men to complete an MDPOA, particularly in younger age groups (P<.001). The primary use of the advance care planning portal tools was the completion of an MDPOA (3138/3292, 95.3{\%}), compared to sending an electronic message (148/3292, 4.5{\%}). Over 50{\%} of patients who completed an MDPOA did not have a prior agent in the EHR. Conclusions: Use of a web-based patient portal to complete an MDPOA increased substantially during the first months of the COVID-19 pandemic in Colorado. There was an increase in advance care planning that corresponded with state government shelter-in-place orders as well as public health reports of increased numbers of COVID-19 cases and deaths. Patient portals are an important tool for providing advance care planning resources and documenting medical decision makers during the pandemic to ensure that medical treatment aligns with patient goals and values. ", issn="1438-8871", doi="10.2196/21385", url="//www.mybigtv.com/2020/8/e21385/", url="https://doi.org/10.2196/21385", url="http://www.ncbi.nlm.nih.gov/pubmed/32716900" }