A randomized controlled trial to improve engagement of hospitalized patients with their patient portals

Abstract

Objectives To test a patient-centered, tablet-based bedside educational intervention in the hospital and to evaluate the efficacy of this intervention to increase patient engagement with their patient portals during hospitalization and after discharge. Materials and Methods We conducted a randomized controlled trial of adult patients admitted to the hospitalist service in one large, academic medical center. All participants were supplied with a tablet computer for 1 day during their inpatient stay and assistance with portal registration and initial login as needed. Additionally, intervention group patients received a focused bedside education to demonstrate key functions of the portal and explain the importance of these functions to their upcoming transition to post-discharge care. Our primary outcomes were proportion of patients who logged into the portal and completed specific tasks after discharge. Secondary outcomes were observed ability to navigate the portal before discharge and self-reported patient satisfaction with bedside tablet use to access the portal. Results We enrolled 97 participants (50 intervention; 47 control); overall 57% logged into their portals ≥1 time within 7 days of discharge (58% intervention vs. 55% control). Mean number of logins was higher for the intervention group (3.48 vs. 2.94 control), and mean number of specific portal tasks performed was higher in the intervention group; however, no individual comparison reached statistical significance. Observed ability to login and navigate the portal in the hospital was higher for the intervention group (64% vs. 60% control), but only 1 specific portal task was significant (view provider messaging tab: 92% vs. 77% control, P = .04). Time needed to deliver the intervention was brief (<15 min for 80%), and satisfaction with the bedside tablet to access the portal was high in the intervention group (88% satisfied/very satisfied). Conclusion Our intervention was highly feasible and acceptable to patients, and we found a highly consistent, but statistically non-significant, trend towards higher inpatient engagement and post-discharge use of key portal functions among patients in the intervention group.

Using Patient and Family Engagement Strategies to Improve Outcomes of Health Information Technology Initiatives: Scoping Review

“…The results from a study by Anshari et al showed that the availability of a Web-based health educator is important to improving the health literacy of patients and empowering patients to control their own health and health information [37]. Greysen et al conducted a randomized controlled trial where patients in the intervention arm received tailored, structured education regarding the use of a patient portal at the bedside [38]. Study results suggested that bedside portal training produced a trend of increased ability to log in and navigate the portal, satisfaction with portal use, and frequency of portal use after discharge.…”

“…The review by Manafo et al documented outcomes when engaging patients in health research that include the following: (1) patients feeling empowered, (2) improved trust between researcher and patients, and (3) decreased attrition of study participants. Increased engagement has also positively impacted health IT projects in different ways such as increased usage of health IT, satisfaction with health IT use [35,37,38], and the obtainment of quality/safety-related outcomes [17]. A review on patient involvement in health research by Shippee et al concluded that available literature on patient involvement focused on 1 research phase and particularly earlier stages of research.…”

Implementation of iPads to Increase Compliance With Delivery of New Parent Education in the Mother–Baby Unit: Retrospective Study

“…The use of iPads to improve delivery of educational material is not a new concept. Specifically, iPads have been useful in the health care setting as a mode of delivering patient education, including education on anticoagulant medication to hospitalized patients, educational materials for patients in acute care, and improvement of inpatients' engagement in their care and patient education in the hospital [21][22][23]. Many of these previous studies have shown an improvement in patients' engagement in their care and education with the use of tablets such as iPads [24,25].…”

Potential of an Electronic Health Record-Integrated Patient Portal for Improving Care Plan Concordance during Acute Care

“…9,12,[15][16][17][18] In recent years, health care systems have been trying to engage patients by offering online access to their health records via patient portals, and reported experiences regarding implementation of patient portals for acute care are now starting to emerge. 15,[19][20][21][22][23][24][25][26][27] Still, few studies have demonstrated meaningful impact on key outcomes, 20,[28][29][30] and to our knowledge, none have demonstrated the potential for using patient portals to improve concordance about the care plan, including recovery goals, among patients and clinicians in the acute care setting. 23,31,32 Improving patient-clinician communication through the meaningful use of patient portals represents a promising strategy to enhance mutual understanding about the plan and facilitate goal-concordant care for seriously ill patients during hospitalization and the transition back to the ambulatory setting.…”