scholarly journals A Novel Digital Platform Approach to Enhance Enterprise-Wide Patient Portal Adoption (Preprint)

2018 ◽  
Author(s):  
Yauheni Solad ◽  
Shrawan Patel ◽  
Allen Hsiao ◽  
Ashish Atreja
Keyword(s):  
Medical Information ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Portal ◽  
New Haven ◽  
Patient Portals ◽  
Digital Platform ◽  
Care Plans ◽  
Number Of Patients ◽  
Haven Hospital

BACKGROUND Patient portals provide a simplified route for health providers to share medical information with individual patients, and are incentivized under Meaningful Use. Currently there are numerous friction factors in the onboarding process of patient portals that limits patients signing up for them. As a result, health systems are spending significant resources to drive the adoption of patient portals, with limited success. OBJECTIVE To evaluate the effectiveness of a innovative rules-driven digital patient engagement strategy for patients to sign up for online patient portal at an academic medical center. METHODS Rx.Universe is a digital platform integrated into provider EMR systems that enables physicians to directly “prescribe” mobile health applications and/or digital care bundles to patients. Rx.Universe Bulk Prescription feature was used to prescribe—via SMS—a direct link to the MyChart login page with the patient’s unique code and personal information embedded within the link. This removed several key barriers to adoption: patients needing to copy and paste access codes, fill in their personal data and complete this process within 30 days—after which their unique access code expires. The Rx.Universe engagement dashboard displayed the total number of patients who received prescribed messages, the number of unsuccessful prescriptions, prescriptions opened in the first 24 hours, and total prescriptions opened. RESULTS We digitally prescribed MyChart Activation to 23,485 patients under the care of Yale-New Haven Hospital over a period of 2 days. Of these prescriptions, 21,997 (93.66%) were successfully delivered and 1488 (6.33%) failed to be delivered because of incorrect cell phone numbers in EHR. Of the prescriptions successfully prescribed, 2170 (9.86%) were clicked within 24 hours of being prescribed with a total of 2378 (10.81%) clicked within a week. CONCLUSIONS Digital Medicine Platforms offer new channel for onboarding and following up patients through customized digital care plans. The power of this approach in removing barriers for patients is highlighted by the fact that Yale-New Haven Hospital met their yearly MyChart adoption target through this campaign within a week. Furthermore, the data could be assessed and acted upon in real-time as opposed to the usual weeks. This technology can be extended to close the care gaps for hospitals and Accountable Care Organizations (ACO) in a scalable manner for a subpopulation, with manual processes reserved for patients unable to be reached in an automated fashion.

scholarly journals Policies and procedures governing patient portal use at an Academic Medical Center

JAMIA Open ◽  
2019 ◽  
Vol 2 (4) ◽  
pp. 479-488
Author(s):  
Bryan D Steitz ◽  
Joseph Isaac S Wong ◽  
Jared G Cobb ◽  
Brian Carlson ◽  
Gaye Smith ◽  
...  
Keyword(s):  
Government Regulation ◽  
Medical Center ◽  
Academic Medical Center ◽  
Successful Implementation ◽  
Patient Portal ◽  
Patient Portals ◽  
Identity Verification ◽  
Policies And Procedures ◽  
Academic Medical ◽  
And Function

Abstract Background and Objective Patient portal use has increased over the last two decades in response to consumer demand and government regulation. Despite growing adoption, few guidelines exist to direct successful implementation and governance. We describe the policies and procedures that have governed over a decade of continuous My Health at Vanderbilt (MHAV) patient portal use. Methods We examined MHAV usage data between May 2007 and November 2017. We classified patient portal activity into eight functional categories: Appointment, Billing, Document Access, Genetics, Health Result, Immunization, Medication, and Messaging. We describe our operating policies and measure portal uptake, patient account activity, and function use over time. Results By the end of the study period, there were 375 517 registered accounts. Policies made MHAV available to competent adults and adolescents 13 and over. Patients signed up for a limited access account online, which could be upgraded to a full-access account after identity verification. Patients could assign proxy accounts to family and caregivers, which permitted nonpatient access to select MHAV functions. Laboratory and radiology results were accessible via MHAV. Results were classified into three groups based on sensitivity, which govern the length of delay before results appeared in MHAV. Discussion and Conclusion Patient portals offer significant opportunity to engage patients in their healthcare. However, there remains a need to understand how policies can promote uptake and use. We anticipate that other institutions can apply concepts from our policies to support meaningful patient portal engagement.

scholarly journals Disparities in Pediatric Patient Portal Activation and Feature Use

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Jennifer H LeLaurin ◽  
Oliver T Nguyen ◽  
Lindsay A Thompson ◽  
Jaclyn Hall ◽  
Jiang Bian ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
White Female ◽  
Patient Portal ◽  
Patient Portals ◽  
Electronic Health Record Data ◽  
Factors Associated ◽  
Academic Medical ◽  
Vulnerable Individual ◽  
Records Access

Abstract Objective Disparities in adult patient portal adoption are well-documented; however, less is known about disparities in portal adoption in pediatrics. This study examines the prevalence and factors associated with patient portal activation and the use of specific portal features in general pediatrics. Materials and methods We analyzed electronic health record data from 2012 to 2020 in a large academic medical center that offers both parent and adolescent portals. We summarized portal activation and use of select portal features (messaging, records access and management, appointment management, visit/admissions summaries, and interactive feature use). We used logistic regression to model factors associated with patient portal activation among all patients along with feature use and frequent feature use among ever users (ie, ≥1 portal use). Results Among 52 713 unique patients, 39% had activated the patient portal, including 36% of patients aged 0–11, 41% of patients aged 12–17, and 62% of patients aged 18–21 years. Among activated accounts, ever use of specific features ranged from 28% for visit/admission summaries to 92% for records access and management. Adjusted analyses showed patients with activated accounts were more likely to be adolescents or young adults, white, female, privately insured, and less socioeconomically vulnerable. Individual feature use among ever users generally followed the same pattern. Conclusions Our findings demonstrate that important disparities persist in portal adoption in pediatric populations, highlighting the need for strategies to promote equitable access to patient portals.

scholarly journals The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study (Preprint)

2019 ◽  
Author(s):  
Brody Foster ◽  
Matthew David Krasowski
Keyword(s):  
Diagnostic Test ◽  
Laboratory Tests ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Portal ◽  
Test Results ◽  
Patient Portals ◽  
Radiology Reports ◽  
Academic Medical ◽  
Laboratory Results

BACKGROUND Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients. OBJECTIVE The study aimed to assess patient portal utilization by ED patients at an academic medical center using account activation rates along with the rates of access of diagnostic test results (laboratory results and radiology reports), analyzing the impact of age, gender, and self-reported patient race. METHODS This institutional review board–approved retrospective study was performed at a 60,000-visits-per-year university-based ED. We utilized EHR data reporting tools to examine EHR portal activation and utilization for all patients who had at least one ED encounter with one or more diagnostic tests performed between October 1, 2016, and October 1, 2017. The total dataset for laboratory testing included 208,635 laboratory tests on 25,361 unique patients, of which 9482 (37.39%) had active portal accounts. The total dataset for radiologic imaging included 23,504 radiology studies on 14,455 unique patients, of which 5439 (37.63%) had an active portal account. RESULTS Overall, 8.90% (18,573/208,635) of laboratory tests and 8.97% (2019/22,504) of radiology reports ordered in the ED were viewed in the patient portal. The highest rates of viewing of laboratory and radiology results were seen for those who were female, were aged 0 to 11 years (parent or guardian viewing by proxy) and 18 to 60 years, and self-reported their race as Caucasian or Asian. The lowest rates were for those who were teenagers, aged older than 81 years, African American/black, and Hispanic/Latino. Infectious disease, urinalysis, and pregnancy testing constituted the highest number of laboratory tests viewed. Magnetic resonance imaging reports were viewed at higher rates than computed tomography or x-ray studies (P<.001). Approximately half of all the diagnostic test results accessed by patients were reviewed within 72 hours of availability in the patient portal (laboratory results: 9904/18,573, 53.32% and radiology reports: 971/2019, 48.1%). On the other extreme, 19.9% (3701/18,573) of laboratory results and 31.6% (639/2019) of radiology reports were viewed more than 2 weeks after availability in the portal. CONCLUSIONS The data highlight the relatively low use of a patient portal by ED patients and existing disparities between patient groups. There can be wide lag time (months) between result/report availability and access by patients. Opportunities for improvement exist for both activation and more robust utilization of patient portals by ED patients.

scholarly journals Metrics for Outpatient Portal Use Based on Log File Analysis: Algorithm Development

10.2196/16849 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e16849
Author(s):  
Gennaro Di Tosto ◽  
Ann Scheck McAlearney ◽  
Naleef Fareed ◽  
Timothy R Huerta
Keyword(s):  
Medical Information ◽  
Medical Center ◽  
Academic Medical Center ◽  
Time Frame ◽  
Median Number ◽  
Patient Portal ◽  
Record System ◽  
User Interactions ◽  
Methodological Choices ◽  
Log File

Background Web-based outpatient portals help patients engage in the management of their health by allowing them to access their medical information, schedule appointments, track their medications, and communicate with their physicians and care team members. Initial studies have shown that portal adoption positively affects health outcomes; however, early studies typically relied on survey data. Using data from health portal applications, we conducted systematic assessments of patients’ use of an outpatient portal to examine how patients engage with the tool. Objective This study aimed to document the functionality of an outpatient portal in the context of outpatient care by mining portal usage data and to provide insights into how patients use this tool. Methods Using audit log files from the outpatient portal associated with the electronic health record system implemented at a large multihospital academic medical center, we investigated the behavioral traces of a study population of 2607 patients who used the portal between July 2015 and February 2019. Patient portal use was defined as having an active account and having accessed any portal function more than once during the study time frame. Results Through our analysis of audit log file data of the number and type of user interactions, we developed a taxonomy of functions and actions and computed analytic metrics, including frequency and comprehensiveness of use. We additionally documented the computational steps required to diagnose artifactual data and arrive at valid usage metrics. Of the 2607 patients in our sample, 2511 were active users of the patients portal where the median number of sessions was 94 (IQR 207). Function use was comprehensive at the patient level, while each session was instead limited to the use of one specific function. Only 17.45% (78,787/451,762) of the sessions were linked to activities involving more than one portal function. Conclusions In discussing the full methodological choices made in our analysis, we hope to promote the replicability of our study at other institutions and contribute to the establishment of best practices that can facilitate the adoption of behavioral metrics that enable the measurement of patient engagement based on the outpatient portal use.

scholarly journals Analysis of Employee Patient Portal Use and Electronic Health Record Access at an Academic Medical Center

2020 ◽  
Vol 11 (03) ◽  
pp. 433-441 ◽  
Author(s):  
Lina Sulieman ◽  
Bryan Steitz ◽  
S. Trent Rosenbloom
Keyword(s):  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Data ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Clinical Notes ◽  
Usage Patterns ◽  
Electronic Health

Abstract Background Patient portals provide patients and their caregivers online access to limited health results. Health care employees with electronic health record (EHR) access may be able to view their health information not available in the patient portal by looking in the EHR. Objective In this study, we examine how employees use the patient portal when they also have access to the tethered EHR. Methods We obtained patient portal and EHR usage logs corresponding to all employees who viewed their health data at our institution between January 1, 2013 and November 1, 2017. We formed three cohorts based on the systems that employees used to view their health data: employees who used the patient portal only, employees who viewed health data in the EHR only, and employees who used both systems. We compared system accesses and usage patterns for each employee cohort. Results During the study period, 35,172 employees accessed the EHR as part of patients' treatment and 28,631 employees accessed their health data: 25,193 of them used the patient portal and 13,318 accessed their clinical data in EHR. All employees who accessed their records in the EHR viewed their clinical notes at least once. Among EHR accesses, clinical note accesses comprised more than 42% of all EHR accesses. Provider messaging and appointment scheduling were the most commonly used functions in the patient portal. Employees who had access to their health data in both systems were more likely to engage with providers through portal messages. Conclusion Employees at a large medical center accessed clinical notes in the EHR to obtain information about their health. Employees also viewed other health data not readily available in the patient portal.

scholarly journals Long-term Patterns of Patient Portal Use for Pediatric Patients at an Academic Medical Center

2017 ◽  
Vol 08 (03) ◽  
pp. 779-793 ◽  
Author(s):  
Robert Cronin ◽  
Sharon Davis ◽  
Ellen Yan ◽  
Gretchen Jackson ◽  
Bryan Steitz
Keyword(s):  
Pediatric Patients ◽  
Medical Center ◽  
Academic Medical Center ◽  
Medical Specialty ◽  
Patient Portal ◽  
Patient Portals ◽  
Secure Messaging ◽  
Patients Âgés ◽  
Academic Medical

SummaryBackground: Patient portal adoption has increased over the last two decades. Most research about patient portals has focused on adult populations in the primary care and medical specialty settings.Objective: We describe initial and long-term portal use by pediatric patients and their caregivers in a broadly deployed patient portal at an academic medical center.Methods: We analyzed portal usage for pediatric patients and their caregivers from 2008 to 2014. We recorded usage events with time stamps; user role defined as self, surrogate (i.e., parent or guardian), or delegate; and functions accessed. Usage events were grouped into sessions to calculate descriptive statistics by patient age, user role, and active use over time.Results: From 2008 to 2014, the number of portal accounts increased from 633 to 17,128. 15.9% of pediatric patients had their own account; 93.6%, a surrogate account; and 2.2% a delegate account. During the study period, 15,711 unique users initiated 493,753 sessions and accessed 1,491,237 functions. Most commonly used functions were secure messaging (accessed in 309,204 sessions; 62.6%); test results (174,239; 35.3%) and appointments (104,830; 21.2%). Function usage was greatest for patients ages 0-2 years (136,245 functions accessed; 23.1%) and 15-17 years (109,241;18.5%). Surrogate users conducted 83.2% of logins for adolescent patients. Portal accounts were actively used for < 1 year for 9,551 patients (55.8%), 1-2 years for 2,826 patients (16.5%), 2–3 years for 1,968 patients (11.5%) and over 3 years for 2,783 patients (16.3%).Conclusion: Pediatric patients and caregivers have avidly used messaging, test result, and appointment functions. The majority of access was done by surrogates. Adolescent portal usage increased with age. Most accounts for pediatric patients were only used actively for a few years, with peak usage for patients in early childhood and late adolescence.Citation: Steitz BD, Cronin RM, Davis SE, Yan Z, Jackson GP. Long-term Patterns of Patient Portal Use for Pediatric Patients at an Academic Medical Center. Appl Clin Inform 2017; 8: 779–793 https://doi.org/10.4338/ACI-2017-01-RA-0005

scholarly journals Characterizing the impact of health literacy, computer ability, patient demographics, and portal usage on patient satisfaction with a patient portal

JAMIA Open ◽  
2019 ◽  
Vol 2 (4) ◽  
pp. 456-464 ◽  
Author(s):  
Joseph Isaac Salientes Wong ◽  
Bryan D Steitz ◽  
Samuel Trent Rosenbloom
Keyword(s):  
Patient Satisfaction ◽  
Health Literacy ◽  
Medical Center ◽  
Computer Control ◽  
Academic Medical Center ◽  
Patient Portal ◽  
Contributing Factors ◽  
Patient Portals ◽  
Patient Demographics ◽  
The Impact

Abstract Objective We sought to measure patient portal satisfaction with patient portals and characterize its relationship to attitude towards computers, health literacy, portal usage, and patient demographics. Materials and Methods We invited 13 040 patients from an academic medical center to complete a survey measuring satisfaction, perceived control over computers, and health literacy using validated instruments (End User Computing Satisfaction, Computer Attitude Measure, and Brief Health Literacy Screen). We extracted portal usage and demographic information from the medical center data warehouse. Results A total of 6026 (46.2%) patients completed the survey. The median (IQR) scores for satisfaction, computer control, and health literacy were 87% (20%), 86% (22%), and 95% (15%), respectively. The normalized mean (SD) usage of messaging, lab, appointment, medication, and immunization functions were 6.6 (2.6), 4.6 (2.4), 3.1 (1.7), 1.5 (1.2), and 0.88 (0.91) times, respectively. Logistic regression yielded significant odds ratios [99% CI] for computer control (3.6 [2.5–5.2]), health literacy (12 [6.9–23]), and immunization function usage (0.84 [0.73–0.96]). Discussion Respondents were highly satisfied and had high degrees of computer control and health literacy. Statistical analysis revealed that higher computer control and health literacy predicted higher satisfaction, whereas usage of the immunization function predicted lower satisfaction. Overall, the analytical model had low predictive capability, suggesting that we failed to capture the main drivers of satisfaction, or there was inadequate variation in satisfaction to delineate its contributing factors. Conclusion This study provides insight into patient satisfaction with and usage of a patient portal. These data can guide the development of the patient portal, with the ultimate goal of increasing functionality and usability to enhance the patient experience.

scholarly journals Metrics for Outpatient Portal Use Based on Log File Analysis: Algorithm Development (Preprint)

2019 ◽  
Author(s):  
Gennaro Di Tosto ◽  
Ann Scheck McAlearney ◽  
Naleef Fareed ◽  
Timothy R Huerta
Keyword(s):  
Medical Information ◽  
Medical Center ◽  
Academic Medical Center ◽  
Time Frame ◽  
Median Number ◽  
Patient Portal ◽  
Record System ◽  
User Interactions ◽  
Methodological Choices ◽  
Log File

BACKGROUND Web-based outpatient portals help patients engage in the management of their health by allowing them to access their medical information, schedule appointments, track their medications, and communicate with their physicians and care team members. Initial studies have shown that portal adoption positively affects health outcomes; however, early studies typically relied on survey data. Using data from health portal applications, we conducted systematic assessments of patients’ use of an outpatient portal to examine how patients engage with the tool. OBJECTIVE This study aimed to document the functionality of an outpatient portal in the context of outpatient care by mining portal usage data and to provide insights into how patients use this tool. METHODS Using audit log files from the outpatient portal associated with the electronic health record system implemented at a large multihospital academic medical center, we investigated the behavioral traces of a study population of 2607 patients who used the portal between July 2015 and February 2019. Patient portal use was defined as having an active account and having accessed any portal function more than once during the study time frame. RESULTS Through our analysis of audit log file data of the number and type of user interactions, we developed a taxonomy of functions and actions and computed analytic metrics, including frequency and comprehensiveness of use. We additionally documented the computational steps required to diagnose artifactual data and arrive at valid usage metrics. Of the 2607 patients in our sample, 2511 were active users of the patients portal where the median number of sessions was 94 (IQR 207). Function use was comprehensive at the patient level, while each session was instead limited to the use of one specific function. Only 17.45% (78,787/451,762) of the sessions were linked to activities involving more than one portal function. CONCLUSIONS In discussing the full methodological choices made in our analysis, we hope to promote the replicability of our study at other institutions and contribute to the establishment of best practices that can facilitate the adoption of behavioral metrics that enable the measurement of patient engagement based on the outpatient portal use.

Management of blood shortages in a tertiary care academic medical center: the Yale-New Haven Hospital frozen blood reserve

Transfusion ◽  
2008 ◽  
Vol 48 (10) ◽  
pp. 2252-2263 ◽  
Author(s):  
Michelle L. Erickson ◽  
Melanie H. Champion ◽  
Roger Klein ◽  
Rebecca L. Ross ◽  
Zena M. Neal ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
New Haven ◽  
Academic Medical ◽  
Haven Hospital

scholarly journals Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study (Preprint)

2020 ◽  
Author(s):  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Amir Alishahi Tabriz ◽  
Christopher M Shea
Keyword(s):  
Patient Characteristics ◽  
Survey Study ◽  
Patient Portal ◽  
Older Individuals ◽  
Patient Portals ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Multiple Variable ◽  
Nationally Representative ◽  
National Trends

BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; <i>P</i>=.01). Older age (OR 1.01, 95% CI 1.00-1.02; <i>P</i>&lt;.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; <i>P</i>&lt;.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; <i>P</i>=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; <i>P</i>&lt;.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; <i>P</i>&lt;.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; <i>P</i>&lt;.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; <i>P</i>&lt;.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.

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