Engaging Diverse Patients in Using an Online Patient Portal

Patient access to online patient portals has shown potential to improve efficiency of care and enable patients to better manage their health, particularly those who have chronic illnesses. These patients need ongoing support and care coordination outside of primary care visits to improve disease management and reduce complications. Lack of system support and education can be a barrier for patients to effectively use patient portals, especially patients traditionally not targeted by health technology dissemination efforts, such as low-income populations. The research team developed and implemented an interactive portal training curriculum, co-designed by patients, and assessed the impact of training on portal use in a safety net healthcare setting.

The specific aims of this research were as follows:

• Design an online training program to educate diverse patients about using a patient portal. 
• Conduct a randomized pilot trial of online training implementation. 

This research developed a training curriculum focused on assisting users in accessing the San Francisco Health Network’s (SFHN's) patient portal, called MySFHealth. The work was informed by 23 patients with chronic diseases and two caregivers with a range of experience in health technology. The research team conducted “think-aloud” interviews, collecting data to inform the development of an online tutorial. Two advisory groups consisting of patients, clinicians, and researchers met twice to review the content of the tutorial, ensuring appropriate and accurate information.

The team then conducted a randomized trial with patients with chronic diseases from two primary care clinics. Patients were randomized to either receive in-person training, or a link to access the online tutorial on their own. Portal enrollment and logins were measured 3 to 6 months post-training, along with patient reports regarding their skills and ability to use the website. While there were no differences in the rates of portal use for those with the in-person training versus the online tutorial, use of the portal was higher for those with any training versus usual care. This suggests that training can increase portal engagement.