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Matthews AK, Steffen AD, Akufo J, Burke L, Diaz H, Dodd D, Hughes A, Madrid S, Onyiapat E, Opuada H, Sejo J, Vilona B, Williams BJ, Donenberg G. Factors Associated with Uptake of Patient Portals at a Federally Qualified Health Care Center. Healthcare (Basel) 2024; 12:1505. [PMID: 39120208 PMCID: PMC11311389 DOI: 10.3390/healthcare12151505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/27/2024] [Accepted: 07/28/2024] [Indexed: 08/10/2024] Open
Abstract
Federally qualified health centers (FQHC) aim to improve cancer prevention by providing screening options and efforts to prevent harmful behavior. Patient portals are increasingly being used to deliver health promotion initiatives. However, little is known about patient portal activation rates in FQHC settings and the factors associated with activation. This study examined patient portal activation among FQHC patients and assessed correlations with demographic, clinical, and health service use variables. We analyzed electronic health record data from adults >18 years old with at least one appointment. Data were accessed from the electronic health records for patients seen between 1 September 2018 and 31 August 2022 (n = 40,852 patients). We used multivariate logistic regression models to examine the correlates of having an activated EPIC-supported MyChart patient portal account. One-third of patients had an activated MyChart portal account. Overall, 35% of patients with an activated account had read at least one portal message, 69% used the portal to schedule an appointment, and 90% viewed lab results. Demographic and clinical factors associated with activation included younger age, female sex, white race, English language, being partnered, privately insured, non-smoking, and diagnosed with a chronic disease. More frequent healthcare visits were also associated with an activated account. Whether or not a patient had an email address in the EHR yielded the strongest association with patient portal activation. Overall, 39% of patients did not have an email address; only 2% of those patients had activated their accounts, compared to 54% of those with an email address. Patient portal activation rates were modest and associated with demographic, clinical, and healthcare utilization factors. Patient portal usage to manage one's healthcare needs is increasing nationally. As such, FQHC clinics should enhance efforts to improve the uptake and usage of patient portals, including educational campaigns and eliminating email requirements for portal activation, to reinforce cancer prevention efforts.
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Affiliation(s)
- Alicia K. Matthews
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Alana D. Steffen
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Jennifer Akufo
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Larisa Burke
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Hilda Diaz
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Darcy Dodd
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Ashley Hughes
- Department of Biomedical and Health Information Science, The University of Illinois Chicago, Chicago, IL 60612, USA;
| | - Samantha Madrid
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Enuma Onyiapat
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Hope Opuada
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | - Jessica Sejo
- College of Medicine, The University of Illinois Chicago, Chicago, IL 60612, USA; (J.S.); (G.D.)
| | - Brittany Vilona
- Department of Population Health Nursing, College of Nursing, The University of Illinois Chicago, Chicago, IL 60612, USA; (A.D.S.); (J.A.); (L.B.); (H.D.); (D.D.); (S.M.); (E.O.); (H.O.); (B.V.)
| | | | - Geri Donenberg
- College of Medicine, The University of Illinois Chicago, Chicago, IL 60612, USA; (J.S.); (G.D.)
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Matthews AK, Steffen A, Burke L, Harris Vilona B, Donenberg G. MiQuit: A Study Protocol to Link Low-Income Smokers to a State Tobacco Quitline. Ethn Dis 2023; DECIPHeR:44-51. [PMID: 38846727 PMCID: PMC11099521 DOI: 10.18865/ed.decipher.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Purpose To conduct a randomized controlled trial to compare 3 implementation strategies and the impact of facilitated referrals on linkage of Federally Qualified Health Center patients to the Illinois Tobacco Quitline (ITQL). Methods This study will be a hybrid type 3 implementation-effectiveness trial guided by 2 implementation science frameworks: reach, effectiveness, adoption, implementation, and maintenance and exploration preparation implementation sustainment. We will evaluate whether sending provider messages through the patient electronic health portal increases patient linkage to the ITQL. We will (1) randomly assign all eligible patients to receive 1 of 3 messages (information about quitting, advice to quit, and advice to quit or cut down), and (2) we will offer a facilitated linkage to the ITQL. For patients who opt into a facilitated referral, we will share their contact information with the ITQL, who will contact them. Four weeks after the initial message, patients who expressed interest in services but were not reached by the ITQL will be rerandomized to 1 of 2 arms, an offer to reconnect to the ITQL or an offer to engage a peer navigator who can help them reconnect to the ITQL. We will assess the implementation strategies' reach, adoption, linkage, and sustainability with the ITQL. Discussion This study will provide a new cost-effective and efficient model to link low-income smokers to state tobacco quitlines. Message delivery via patient health portals has important implications for addressing other tobacco-related morbidities.
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Affiliation(s)
- Alicia K. Matthews
- Behavioral Science, School of Nursing, Columbia University, New York, NY
| | - Alana Steffen
- College of Nursing, The University of Illinois Chicago, Chicago, IL
| | - Larisa Burke
- College of Nursing, The University of Illinois Chicago, Chicago, IL
| | - Brittany Harris Vilona
- Department of Medicine, Center for Dissemination and Implementation Science, University of Illinois at Chicago, Chicago, IL
| | - Geri Donenberg
- Department of Medicine, Center for Dissemination and Implementation Science, University of Illinois at Chicago, Chicago, IL
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Mensah GA, Murray DM. Deciphering Disparities: The NHLBI Program on Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR). Ethn Dis 2023; DECIPHeR:1-5. [PMID: 38846734 PMCID: PMC11099529 DOI: 10.18865/ed.decipher.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Despite several ambitious national health initiatives to eliminate health disparities, spanning more than 4 decades, health disparities remain pervasive in the United States. In an attempt to bend the curve in disparities elimination, the National Heart, Lung, and Blood Institute (NHLBI) issued a funding opportunity on Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) in March 2019. Seven implementation research centers and 1 research coordinating center were funded in September 2020 to plan, develop, and test effective implementation strategies for eliminating disparities in heart and lung disease risk. In the 16 articles presented in this issue of Ethnicity & Disease, the DECIPHeR Alliance investigators and their NHLBI program staff address the work accomplished in the first phase of this biphasic research endeavor. Included in the collection are an article on important lessons learned during technical assistance sessions designed to ensure scientific rigor in clinical study designs, and 2 examples of clinical study process articles. Several articles show the diversity of clinical and public health settings addressed including schools, faith-based settings, federally qualified health centers, and other safety net clinics. All strategies for eliminating disparities tackle a cardiovascular or pulmonary disease and related risk factors. In an additional article, NHLBI program staff address expectations in phase 2 of the DECIPHeR program, strategies to ensure feasibility of scaling and spreading promising strategies identified, and opportunities for translating the DECIPHeR research model to other chronic diseases for the elimination of related health disparities.
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Affiliation(s)
- George A. Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - David M. Murray
- Office of Disease Prevention, National Institutes of Health, Bethesda, MD
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