Targeted Electronic Patient Portal Messaging Increases Hepatitis C Virus Screening in Primary Care: a Randomized Study

Halket, Douglas; Dang, Jimmy; Phadke, Anuradha; Jayasekera, Channa R.; Kim, W Ray; Kwo, Paul Y.; Downing, Lance; Goel, Aparna

doi:10.1007/s11606-022-07460-1

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Szilagyi et al [ 34 ] demonstrated a small increase in influenza vaccination rates (on the order of 1%-3%) for patients receiving portal messages versus those not receiving one, but the authors did not study the delivery of the message in targeted versus blast approaches as we did. By contrast, Halket et al [ 35 ] studied the use of targeted electronic portal messaging for hepatitis C screening. More specifically, they studied the effect of sending a patient portal message for patients having an appointment in the upcoming 6 months compared with sending this message to those without an upcoming visit.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Efficacy of Targeted and Blast Portal Messaging in Message Opening Rate and Anticoagulation Initiation in Patients With Atrial Fibrillation in the Preventing Preventable Strokes Study II: Prospective Cohort Study

Kapoor,

Patel,

Chennupati

et al. 2024

JMIR Cardio

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Background The gap in anticoagulation use among patients with atrial fibrillation (AF) is a major public health threat. Inadequate patient education contributes to this gap. Patient portal–based messaging linked to educational materials may help bridge this gap, but the most effective messaging approach is unknown. Objective This study aims to compare the responsiveness of patients with AF to an AF or anticoagulation educational message between 2 portal messaging approaches: sending messages targeted at patients with upcoming outpatient appointments 1 week before their scheduled appointment (targeted) versus sending messages to all eligible patients in 1 blast, regardless of appointment scheduling status (blast), at 2 different health systems: the University of Massachusetts Chan Medical School (UMass) and the University of Florida College of Medicine-Jacksonville (UFL). Methods Using the 2 approaches, we sent patient portal messages to patients with AF and grouped patients by high-risk patients on anticoagulation (group 1), high-risk patients off anticoagulation (group 2), and low-risk patients who may become eligible for anticoagulation in the future (group 3). Risk was classified based on the congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age between 65 and 74 years, and sex category (CHA2DS2-VASc) score. The messages contained a link to the Upbeat website of the Heart Rhythm Society, which displays print and video materials about AF and anticoagulation. We then tracked message opening, review of the website, anticoagulation use, and administered patient surveys across messaging approaches and sites using Epic Systems (Epic Systems Corporation) electronic health record data and Google website traffic analytics. We then conducted chi-square tests to compare potential differences in the proportion of patients opening messages and other evaluation metrics, adjusting for potential confounders. All statistical analyses were performed in SAS (version 9.4; SAS Institute). Results We sent 1686 targeted messages and 1450 blast messages. Message opening was significantly higher with the targeted approach for patients on anticoagulation (723/1156, 62.5% vs 382/668, 57.2%; P=.005) and trended the same in patients off anticoagulation; subsequent website reviews did not differ by messaging approach. More patients off anticoagulation at baseline started anticoagulation with the targeted approach than the blast approach (adjusted percentage 9.3% vs 2.1%; P<.001). Conclusions Patients were more responsive in terms of message opening and subsequent anticoagulation initiation with the targeted approach.

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Section: Discussionmentioning

confidence: 99%

Comparing the Efficacy of Targeted and Blast Portal Messaging in Message Opening Rate and Anticoagulation Initiation in Patients With Atrial Fibrillation in the Preventing Preventable Strokes Study II: Prospective Cohort Study

Kapoor,

Patel,

Chennupati

et al. 2024

JMIR Cardio

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“…A significant contributor to poor uptake is poor knowledge of the benefits of screening (e.g., perceived benefit) and a lack of perceived susceptibility and severity of lung cancer among screening-eligible patients [12][13][14][15][16]. Guided by the Health Belief Model (HBM) and leveraging an electronic health record (EHR) patient portal direct messaging feature, the tool is a multilevel theory-based conceptual model that targets behavior change in LCS uptake to engage potentially eligible patients in preventative screening [17,18].…”

Section: Introductionmentioning

confidence: 99%

Development of an Electronic Health Record Self-Referral Tool for Lung Cancer Screening: One-Group Posttest Study

Stang,

Tanner,

Hatch

et al. 2024

JMIR Form Res

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Background: Approximately 14 million individuals in the U.S. are eligible for lung cancer screening (LCS), but only 5.8% completed screening in 2021. Given the low uptake despite the potential great health benefit of LCS, interventions aimed at increasing uptake are warranted.Objective: This study sought to develop and pilot an electronic health record (EHR) patient-facing self-referral tool to an established LCS program in an academic medical center. Methods:Guided by constructs of the Health Belief Model associated with LCS uptake (e.g., knowledge, self-efficacy), formative development of an EHR-delivered engagement message, infographic, and self-referring survey was conducted. The survey submits eligible self-reported patient information to a scheduler for the LCS program. The materials were pretested using an interviewer-administered mixed-methods survey captured through venue-day-time sampling in five network-affiliated pulmonology clinics. Materials were then integrated into the secure patient messaging feature in the EHR system. Next, a onegroup posttest quality improvement pilot test was conducted.Results: Seventeen individuals presenting for lung screening shared-decision visits completed the pretest survey. More than half were newly referred for LCS (n=10, 58.8%), and the remaining were returning patients. When asked if they would use a selfreferring tool through their EHR messaging portal, 94.12% (n=16) reported yes. Fifteen participants provided oral feedback that led to refinement in the tool and infographic prior to pilot testing. When the initial application of the tool was sent to a convenience sample of 150 random patients, 13.3% (n=20) opened the self-referring survey. Of the 20, 45.0% (n=9) were eligible for LCS based on self-reported smoking data. Three self-referring individuals scheduled a LCS. Conclusions:Pretest and initial application data suggest this tool is a positive stimulus to trigger the decision-making process to engage in self-referral process to LCS among eligible patients. This self-referral tool may increase the number of patients engaging in LCS and could also be used to aid in self-referral to other preventative health screenings.

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Hepatitis C Screening in Post–Baby Boomer Generation Americans: One Size Does Not Fit All

Sripongpun,

Udompap,

Mannalithara

et al. 2023

Mayo Clinic Proceedings

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Targeted Electronic Patient Portal Messaging Increases Hepatitis C Virus Screening in Primary Care: a Randomized Study

Cited by 6 publications

References 24 publications

Comparing the Efficacy of Targeted and Blast Portal Messaging in Message Opening Rate and Anticoagulation Initiation in Patients With Atrial Fibrillation in the Preventing Preventable Strokes Study II: Prospective Cohort Study

Comparing the Efficacy of Targeted and Blast Portal Messaging in Message Opening Rate and Anticoagulation Initiation in Patients With Atrial Fibrillation in the Preventing Preventable Strokes Study II: Prospective Cohort Study

Development of an Electronic Health Record Self-Referral Tool for Lung Cancer Screening: One-Group Posttest Study

Hepatitis C Screening in Post–Baby Boomer Generation Americans: One Size Does Not Fit All

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