Characteristics of Women Enrolled in a Patient Portal Intervention for Menopause

Abstract

Background: We developed a 6-month educational intervention addressing menopause and management of menopausal symptoms called ''My HealtheVet to Enable And Negotiate for Shared decision-making'' or MEANS. MEANS is offered through secure messaging via the My HealtheVet patient portal system. Materials and Methods: Women veterans aged 45-60 years registered at the Miami, West Palm Beach, and Orlando Veterans Affairs Healthcare Systems (VAHS). Intervention group: women in the Miami VAHS enrolled in My HealtheVet who were sent an invitation, agreed to participate, and completed the baseline survey. Comparison group: women from the Miami, West Palm Beach, and Orlando VAHS who responded to the baseline survey. Results: The intervention group enrolled 269 women at Miami VAHS: average age 53.2 years; 42.4% white, 43.1% black, and 24.2% Hispanic; 95.9% already used My Healthe Vet. The Comparison group had 590 women: average age 53.8 years; 70.8% white, 20.7% black, and 10.2% Hispanic; 57.6% already used My Healthe Vet. Conclusions: The differences between the intervention and comparison groups likely represent the regional demographic variations and the disparate recruitment techniques adopted for the two groups. Using within-and betweengroup comparisons at the end of the 6-month intervention, this novel project will evaluate the feasibility of a patient portal intervention on knowledge and shared decision-making regarding menopause among racially and ethnically diverse women. The study highlights the scalable and enormous potential for patient portals in nonurgent chronic disease management and shared decision-making, important in the existing health care climate, wherein ''meaningful use' ' of electronic health records is mandated. Because of the COVID-19 pandemic, medical care has abruptly changed to telehealth and this approach to patient education is more relevant now than ever before. This quality improvement project's registration number is ClinicalTrials.gov ID: NCT03109145.

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

“…New care processes and workflow changes involving many different stakeholders were needed to successfully transition to telehealth, including changes to scheduling, the additional preparations needed prior to virtual visits (e.g., patient portal enrollment, virtual processes for previsit questionnaires), conversion of in-person processes to the virtual context (e.g., "rooming"), and postvisit follow-up, [47][48][49][50][51][52][53] as well as increased remote disease monitoring and virtual patient education programs. 54 To achieve these changes, HCOs also needed to employ implementation strategies to encourage acceptance among the various stakeholders. We found that existing literature was more likely to describe health care professional-facing implementation strategies to encourage acceptance of virtual visits than patient- • New virtual care processes were required for all stages of a visit-previsit such as patient portal enrollment, during such as "rooming," and postvisit follow-up-as well as remote disease monitoring and patient education.…”

“…We found that existing literature was more likely to describe health care professional-facing implementation strategies to encourage acceptance of virtual visits than patient- • New virtual care processes were required for all stages of a visit-previsit such as patient portal enrollment, during such as "rooming," and postvisit follow-up-as well as remote disease monitoring and patient education. [47][48][49][50][51][52][53][54] • The literature describes a wide variety of clinician-facing, sociotechnical implementation strategies, including securing and organizing human resources (e.g., clinician champions); developing guidelines, standard scripts, and best practices; offering trainings and clearly communicating evolving processes and resources; and leveraging technological resources. [47][48][49][50][51][52][53]55 • The patient-facing initiatives reported in the literature are limited to technological training and support, with an emphasis on mitigating the risk of digital health disparities.…”