Engaging Diverse Patients in Using an Online Patient Portal (California)

Project abstract as submitted in the grant proposal.

This grant is an AHRQ Patient-Centered Outcomes Research (PCOR) Pathway to Independence Award (K99/R00) for Dr. Courtney Lyles, PhD, a health services researcher at the University of California San Francisco, who is establishing herself as a young investigator examining health information technology use among diverse diabetes patients. This award will provide her with the support to transition to an independent academic researcher and to accomplish the following goals: 1) to become an expert in using comparative effectiveness research methods to understand the influence of online patient portal use on diabetes outcomes within racial and ethnic minority groups; 2) to employ qualitative and implementation science skills to understand barriers to portal use, and to design a new approach to patient engagement; and 3) to apply these rigorous approaches within an integrated delivery system with a mature electronic system (Kaiser Permanente Northern California) and a safety net public hospital system currently implementing an online patient portal (San Francisco General Hospital (SFGH)).

Although there are marked racial and ethnic disparities in portal use nationwide, little is known about how to engage diverse patients in utilizing these technologies to extend their care beyond in-person office visits to improve diabetes self-care and management. In Aim 1, the link between portal use and diabetes outcomes will be determined as measured by adherence, missed appointments, and clinical control among racial and ethnic minority patients at Kaiser. In Aim 2, barriers to portal use among diabetes patients at UCSF will be qualitatively assessed, employing user-centered design methodologies. And finally, in Aim 3, a novel program will be designed and tested that addresses patient-reported barriers to use and train SFGH patients to access the portal as part of their care routine. This work to actively engage a broader and more diverse group of patients in using new health information technology such as portals has the potential to improve health outcomes and reduce overall disparities in care.