Effect of In-Person vs Video Training and Access to All Functions vs a Limited Subset of Functions on Portal Use Among Inpatients

Abstract

IMPORTANCE Inpatient portals provide patients with clinical data and information about their care and have the potential to influence patient engagement and experience. Although significant resources have been devoted to implementing these portals, evaluation of their effects has been limited. OBJECTIVETo assess the effects of patient training and portal functionality on use of an inpatient portal and on patient satisfaction and involvement with care. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted fromDecember 15, 2016, to August 31, 2019, at 6 noncancer hospitals that were part of a single health care system. Patients who were at least 18 years of age, identified English as their preferred language, were not involuntarily confined or detained, and agreed to be provided a tablet to access the inpatient portal during their stay were eligible for participation. Data were analyzed from May 1, 2019, to March 15, 2021. INTERVENTIONS A 2 × 2 factorial intervention design was used to compare 2 levels of a training intervention (touch intervention, consisting of in-person training vs built-in video tutorial) and 2 levels of portal function availability (tech intervention) within an inpatient portal (all functions operational vs a limited subset of functions). MAIN OUTCOMES AND MEASURESThe primary outcomes were inpatient portal use, measured by frequency and comprehensiveness of use, and patients' satisfaction and involvement with their care. RESULTSOf 2892 participants, 1641 were women (56.7%) with a median age of 47.0 (95% CI, 46.0-48.0) years. Most patients were White (2221 [76.8%]). The median Charlson Comorbidity Index was 1 (95% CI, 1-1) and the median length of stay was 6 (95% CI, 6-7) days. Notably, the in-person training intervention was found to significantly increase inpatient portal use (incidence rate ratio, 1.34 [95% CI, 1.25-1.44]) compared with the video tutorial. Patients who received in-person training had significantly higher odds of being comprehensive portal users than those who received the video tutorial (odds ratio, 20.75 [95% CI,). Among patients who received the full-tech intervention, those who also received the in-person intervention used the portal more frequently (incidence rate ratio, 1.36 [95% CI, 1.25-1.48]) and more comprehensively (odds ratio, 22.52; [95% CI,) than those who received the video tutorial. Patients who received in-person training had higher odds (OR, 2.01 [95% CI, 1.16-3.50]) of reporting being satisfied in the 6-month postdischarge survey. Similarly, patients who received the full-tech intervention had higher odds (OR, 2.06 [95%CI,) of reporting being satisfied in the 6-month postdischarge survey. (continued) Key Points Question How do training and technology functions of an inpatient portal affect portal use, patient satisfaction, and patient involvement in their care while hospitalized? Findings In this randomized clinical trial of 2892 participants, patients who had access to in-person training (compared with a training video) or more por...

Differences by Race in Outcomes of an In-Person Training Intervention on Use of an Inpatient Portal

“…The rationale, design, 35 and primary study findings from the HT2 study have been published. 34 The study used a 2-by functions (ie, dining on demand; bedside tutorial; to learn) (see eTable 1 in Supplement 1 for additional information about functions). A complete description of the intervention, including the approach to recruitment and data collection, is available in the study protocol (Supplement 2).…”

“…Our study leverages data collected as part of a randomized controlled trial (RCT)—the High-Tech and High-Touch (HT2) study—conducted across 6 hospitals that were part of a single academic health care system in the Midwest. The rationale, design, and primary study findings from the HT2 study have been published . The study used a 2-by-2 factorial design to concurrently test the individual and joint effects of 2 interventions: (1) touch: in-person (ie, high-touch) vs a video tutorial (ie, low-touch) training on how to use the inpatient portal; and (2) technology: a fully functional version of an inpatient portal (ie, full technology) vs a version with limited functionality (ie, lite technology).…”

“…Our results follow the Consolidated Standards of Reporting Trials (CONSORT) reporting guideline. The original study protocol was updated in November 2023 to correct errors concerning protocol deviations that resulted in reallocation of participants who did not receive their originally allocated intervention . The revised protocol as well as the original protocol are included in Supplement 2.…”

“…Recent evidence from a randomized clinical trial demonstrated that in-person portal training and/or access to full functionality on an inpatient portal can increase use of an inpatient portal and patient satisfaction and involvement in their care, 34…”

Notice of Retraction and Replacement. McAlearney et al. Effect of In-Person vs Video Training and Access to All Functions vs a Limited Subset of Functions on Portal Use Among Inpatients: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(9):e2231321

“…To the Editor On behalf of our coauthors, we write to explain errors in the Original Investigation, “Effect of In-Person vs Video Training and Access to All Functions vs a Limited Subset of Functions on Portal Use Among Inpatients: A Randomized Clinical Trial,” published on September 13, 2022, in JAMA Network Open. This trial was conducted to assess the effects of patient training and portal functionality on use of an inpatient portal and on patient satisfaction and involvement with care among 2892 adult hospitalized participants.…”