The Impact of an Education Bundle on Patient Utilization of the Online Portal System and Associated Smartphone Application

Purpose: The purpose of this project is to evaluate the effectiveness of an education bundle on increasing patient knowledge and utilization of the portal system by patients seeking care in federally qualified health centers (FQHCs).

Background/significance: Patient utilization of portal systems continues to be low despite widespread availability (Zhao et al., 2017). In 2017, patient self-reported use of portal systems was only 28% in the United States (Grossman et al., 2019). Lack of knowledge, computer skills, and internet access, along with privacy concerns, patient demographics, and lack of provider buy-in, are potential barriers to utilization of portal systems (Zhao et al., 2017). Underserved populations, such as individuals of low socioeconomic status, racial/ethnic minorities, those with chronic illnesses and/or disabilities, and the elderly, often have decreased levels of health literacy and are less likely to use patient portal systems (Grossman et al., 2019). Use of the portal system may lead to increased health literacy and help to overcome some of the barriers to achieving health equity in these populations (Grossman et al., 2019). Prior research on this topic is limited and excludes Spanish-speaking patients. Effective strategies to increase utilization of portal systems in underserved populations are needed and can potentially be addressed with implementation of bundled education interventions.

Methods: To increase patients’ knowledge and use of the portal system, researchers created and implemented an education bundle at two rural FQHCs providing care to underserved populations, in which approximately 16% of the population is best served in a language other than English. The bundle consists of staff/provider in-services, training of a portal resource staff person at each site, instructional videos on the clinics’ website, informational and instructional brochures, and informational flyers posted in patient rooms and at registration. All patient educational materials are in English and Spanish.

To assess effectiveness of the education bundle on increasing use of the portal system, researchers will compare the number of medication refill requests 4 months prior to and 4 months after implementation of the education bundle. Additionally, researchers will review results of an anonymous portal system patient satisfaction survey collected by the clinics during the spring of 2020 and conduct a voluntary follow-up patient satisfaction survey 4 months after implementation of the education bundle. The survey will be available in both English and Spanish.

Results: Data collection and analysis for this project are ongoing and will be completed in January 2021 and included on the poster presentation if invited to participate. Descriptive statistics and independent group tests will be used. Based on the level of measurement for the data analyzed, Chi-square test will be used. General comparisons of the aggregate data percentages will be used to evaluate clinical significance.

Conclusions/implications: This study aims to determine the effectiveness of an education bundle on increasing patient knowledge and use of the portal system. The results can potentially be used to support the continued use of an education bundle to inform patients of portal systems and their functions and increase access for English- and Spanish-speaking patients.