Changes in patient portal adoption due to the emergence of COVID-19 pandemic.

Even though patient portals are recognized as a promising mechanism to support greater patient engagement, questions remain about access and utilization. This study aims to identify factors related to portal adoption in 2019 and 2020 (before and during the COVID-19). Cross-sectional data from the Health Information National Trends Survey (HINTS) cycles- 2019 HINTS 5 cycle 3 (N = 5,438) and 2020 HINTS 5 cycle 4 (N = 3,865) were analyzed using STATA-SE version 17 to factors predicting portal adoption. Next, HINTS 5 cycles 3 and 4 were pooled to identify changes in portal feature use and ease of usage among portal users, and barrier to portal use among non-users. Respondents who were college graduates, high income, and married were more likely to adopt patient portals during 2019 and 2020. Aged 75+ and Hispanic respondents reported less frequency of portal access in 2020 versus 2019. Men were more likely to adopt patient portals in 2019 versus women in 2020. Portal users were more likely to use the portal-system features in 2019 versus 2020. Portal non-users reported having multiple-health records as less of a barrier in 2020 compared to 2019. Patient engagement needs heightened attention during the COVID-19 pandemic.

The COVID-19 pandemic has changed dying and grief: Will there be a surge of complicated grief?

Worldwide, more than 3 million people have died from COVID-19. Each decedent represents a person who was loved, will be missed, and whose death elicited grief. COVID-19 has changed the way we die and grieve. Many people have died without family members and friends present and many of the bereft have grieved and mourned alone. Individuals and communities have experienced multiple losses within a short time while suffering from concomitant stress, anxiety, and depression. More deaths and more grief will continue in the foreseeable future. Preventive education is needed to prepare for and manage the likely increase in complicated grief.

COVID-19 brings a new urgency for advance care planning: Implications of death education.

The U.S. has the highest number of coronavirus disease (COVID-19) cases and deaths of any nation. Deaths due to COVID-19, especially among older adults and people of color, have created an urgency for advanced care planning (ACP). Despite benefits of ACP, only one-third of U.S. adults have completed advance directives, in part due to a lack of death education. We recommend four actions to increase death education and ACP completion: (1) integrate death education into teacher preparation programs, (2) incorporate death education in undergraduate curricula, (3) provide better education in death and dying to future health professionals, and (4) educate the public.