Patient Portal Use Among Diabetic Patients With Different Races and Ethnicities

Wang, Hao; Kirby, Ryan; Pierce, Aimee; Barbaro, Michael; Ho, Amy F.; Blalock, Jake; Schrader, Chet D.

doi:10.14740/jocmr4822

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…The study hospital ED has approximately 125,000 annual patient visits. The entire hospital system uses electronic medical records (Epic) and a patient portal system (MyChart) that is assigned to each patient [ 25 ]. Patient portals can be entered by either using a computer via a website or a tablet/smartphone via an app.…”

Section: Methodsmentioning

confidence: 99%

Using Machine Learning Algorithms to Predict Patient Portal Use Among Emergency Department Patients With Diabetes Mellitus

Zhou

Swoboda²,

et al. 2023

J Clin Med Res

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Background Different machine learning (ML) technologies have been applied in healthcare systems with diverse applications. We aimed to determine the model feasibility and accuracy of predicting patient portal use among diabetic patients by using six different ML algorithms. In addition, we also compared model performance accuracy with the use of only essential variables. Methods This was a single-center retrospective observational study. From March 1, 2019 to February 28, 2020, we included all diabetic patients from the study emergency department (ED). The primary outcome was the status of patient portal use. A total of 18 variables consisting of patient sociodemographic characteristics, ED and clinic information, and patient medical conditions were included to predict patient portal use. Six ML algorithms (logistic regression, random forest (RF), deep forest, decision tree, multilayer perception, and support vector machine) were used for such predictions. During the initial step, ML predictions were performed with all variables. Then, the essential variables were chosen via feature selection. Patient portal use predictions were repeated with only essential variables. The performance accuracies (overall accuracy, sensitivity, specificity, and area under receiver operating characteristic curve (AUC)) of patient portal predictions were compared. Results A total of 77,977 unique patients were placed in our final analysis. Among them, 23.4% (18,223) patients were diabetic mellitus (DM). Patient portal use was found in 26.9% of DM patients. Overall, the accuracy of predicting patient portal use was above 80% among five out of six ML algorithms. The RF outperformed the others when all variables were used for patient portal predictions (accuracy 0.9876, sensitivity 0.9454, specificity 0.9969, and AUC 0.9712). When only eight essential variables were chosen, RF still outperformed the others (accuracy 0.9876, sensitivity 0.9374, specificity 0.9932, and AUC 0.9769). Conclusion It is possible to predict patient portal use outcomes when different ML algorithms are used with fair performance accuracy. However, with similar prediction accuracies, the use of feature selection techniques can improve the interpretability of the model by addressing the most relevant features.

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Section: Methodsmentioning

confidence: 99%

Using Machine Learning Algorithms to Predict Patient Portal Use Among Emergency Department Patients With Diabetes Mellitus

Zhou

Swoboda²,

et al. 2023

J Clin Med Res

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Recommendations to Address Barriers to Patient Portal Use Among Persons With Diabetes Seeking Care at Community Health Centers: Interview Study With Patients and Health Care Providers

Akyirem,

Wagner,

Chen

et al. 2024

JMIR Diabetes

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Background: Community Health Centers (CHCs) are safety-net healthcare facilities in the US that provide care for a substantial number of low-income, non-English speaking adults with type 2 diabetes (T2D). Whereas patient portals have been shown to be associated with significant improvements in diabetes self-management and outcomes, they remain underutilized in CHCs. Additionally, little is known about the specific barriers and facilitators to patient portal use in CHCs as well as strategies to address the barriers. Objective:The objective of this qualitative study was to explore the barriers and facilitators of the use of patient portals for managing diabetes in two CHCs from the perspective of adults with T2D and clinicians (community health workers, nurses, nurse practitioners, and physicians) and to make recommendations on strategies to enhance usage Methods: A qualitative description design was used. Twenty-one participants (13 clinicians and 8 adults with T2D) were purposively and conveniently selected from two CHCs. Adults with T2D were included if they were an established patient of one of the partner CHCs, ?18 years old, diagnosed with T2D ? 6 months, and able to read English or Spanish. Clinicians at our partner CHCs who provided care/services for adults with T2D were eligible for this study. Semi-structured interviews were conducted in either Spanish or English based on participant preference. Interviews were audio-recorded and transcribed. Spanish interviews were translated into English by a bilingual research assistant. Data were analyzed using a rapid content analysis method. Standards of rigor were implemented.Results: Themes generated from interviews included perceived usefulness and challenges of the patient portal, strategies to improve patient portal use, and challenges in diabetes self-management. Participants were enthusiastic about the potential of the portal to improve access to health information and patient-provider communication. However, challenges of health/technology literacy, maintaining engagement, and clinician burden were identified. Standardized implementation strategies were recommended to raise awareness of patient portal benefits, provide simplified training and technology support, change clinic workflow to triage messages, customize portal notification messages, minimize clinician burden, and enhance the ease with which blood glucose data can be uploaded into the portal.Conclusions: Adults with T2D and providers at CHCs continue to report pervasive challenges to patient portal use in CHCs.Providing training and technical support on patient portal use for patients with low literacy and implementing standardized patient portal use strategies to address the unique needs of patients receiving care at CHCs have potential to improve health equity and health outcomes associated with patient portal use.

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Recommendations to Address Barriers to Patient Portal Use Among Persons With Diabetes Seeking Care at Community Health Centers: Interview Study With Patients and Health Care Providers (Preprint)

Akyirem,

Wagner,

Chen

et al. 2024

Preprint

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BACKGROUND Community Health Centers (CHCs) are safety-net healthcare facilities in the US that provide care for a substantial number of low-income, non-English speaking adults with type 2 diabetes (T2D). Whereas patient portals have been shown to be associated with significant improvements in diabetes self-management and outcomes, they remain underutilized in CHCs. Additionally, little is known about the specific barriers and facilitators to patient portal use in CHCs as well as strategies to address the barriers. OBJECTIVE The objective of this qualitative study was to explore the barriers and facilitators of the use of patient portals for managing diabetes in two CHCs from the perspective of adults with T2D and clinicians (community health workers, nurses, nurse practitioners, and physicians) and to make recommendations on strategies to enhance usage METHODS A qualitative description design was used. Twenty-one participants (13 clinicians and 8 adults with T2D) were purposively and conveniently selected from two CHCs. Adults with T2D were included if they were an established patient of one of the partner CHCs, ≥18 years old, diagnosed with T2D ≥ 6 months, and able to read English or Spanish. Clinicians at our partner CHCs who provided care/services for adults with T2D were eligible for this study. Semi-structured interviews were conducted in either Spanish or English based on participant preference. Interviews were audio-recorded and transcribed. Spanish interviews were translated into English by a bilingual research assistant. Data were analyzed using a rapid content analysis method. Standards of rigor were implemented. RESULTS Themes generated from interviews included perceived usefulness and challenges of the patient portal, strategies to improve patient portal use, and challenges in diabetes self-management. Participants were enthusiastic about the potential of the portal to improve access to health information and patient-provider communication. However, challenges of health/technology literacy, maintaining engagement, and clinician burden were identified. Standardized implementation strategies were recommended to raise awareness of patient portal benefits, provide simplified training and technology support, change clinic workflow to triage messages, customize portal notification messages, minimize clinician burden, and enhance the ease with which blood glucose data can be uploaded into the portal. CONCLUSIONS Adults with T2D and providers at CHCs continue to report pervasive challenges to patient portal use in CHCs. Providing training and technical support on patient portal use for patients with low literacy and implementing standardized patient portal use strategies to address the unique needs of patients receiving care at CHCs have potential to improve health equity and health outcomes associated with patient portal use.

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Patient Portal Use Among Diabetic Patients With Different Races and Ethnicities

Cited by 3 publications

References 32 publications

Using Machine Learning Algorithms to Predict Patient Portal Use Among Emergency Department Patients With Diabetes Mellitus

Using Machine Learning Algorithms to Predict Patient Portal Use Among Emergency Department Patients With Diabetes Mellitus

Recommendations to Address Barriers to Patient Portal Use Among Persons With Diabetes Seeking Care at Community Health Centers: Interview Study With Patients and Health Care Providers

Recommendations to Address Barriers to Patient Portal Use Among Persons With Diabetes Seeking Care at Community Health Centers: Interview Study With Patients and Health Care Providers (Preprint)

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