Abstract
BackgroundHealth care systems have entered a new era focused on patient engagement. Patient portals linked to electronic health records are recognized as a promising multifaceted tool to help achieve patient engagement goals. Achieving significant growth in adoption and use requires agile evaluation methods to complement periodic formal research efforts.ObjectiveThis paper describes one of the implementation strategies that the Department of Veterans Affairs (VA) has used to foster the adoption and sustained use of its patient portal, My HealtheVet, over the last decade: an ongoing focus on user-centered design (UCD). This strategy entails understanding the users and their tasks and goals and optimizing portal design and functionality accordingly. Using a case study approach, we present a comparison of early user demographics and preferences with more recent data and several examples to illustrate how a UCD can serve as an effective implementation strategy for a patient portal within a large integrated health care system.MethodsVA has employed a customer experience analytics (CXA) survey on its patient portal since 2007 to enable ongoing direct user feedback. In a continuous cycle, a random sample of site visitors is invited to participate in the Web-based survey. CXA model questions are used to track and trend satisfaction, while custom questions collect data about users’ characteristics, needs, and preferences. In this case study, we performed analyses of descriptive statistics comparing user characteristics and preferences from FY2008 (wherein “FY” means “fiscal year”) to FY2017 and user trends regarding satisfaction with and utilization of specific portal functions over the last decade, as well as qualitative content analysis of user’s open-ended survey comments.ResultsUser feedback has guided the development of enhancements to core components of the My HealtheVet portal including available features, content, interface design, prospective functional design, and related policies. Ten-year data regarding user characteristics and portal utilization demonstrate trends toward greater patient engagement and satisfaction. Administration of a continuous voluntary Web-based survey is an efficient and effective way to capture veterans’ voices about who they are, how they use the patient portal, needed system improvements, and desired additional services.ConclusionsLeveraging “voice-of-the-customer” techniques as part of patient portal implementation can ensure that such systems meet users’ needs in ways that are agile and most effective. Through this strategy, VA has fostered significant adoption and use of My HealtheVet to engage patients in managing their health.
Highlights
BackgroundHealth care systems have entered a new era focused on patient engagement [1-3] described by enthusiasts as “the holy grail of health care” [4] and the “blockbuster drug of the century” [5]
This paper presents selected analyses of the customer experience analytics (CXA) survey data collected over a course of 10 years, including a comparison of data collected early in the implementation of My HealtheVet (FY2008) to more recent data (FY2017), to examine the characteristics of patient portal users and their preferences
Following our case study approach, we provide selected examples from the My HealtheVet evaluation program to illustrate how different assessments that capture the voice of the customer have directly informed the evolution of the portal and the addition of new functionality
Summary
BackgroundHealth care systems have entered a new era focused on patient engagement [1-3] described by enthusiasts as “the holy grail of health care” [4] and the “blockbuster drug of the century” [5]. Patient portals linked to electronic health records (EHRs) are recognized as a promising multifaceted tool to help achieve these patient engagement goals [6-9]. Positive benefits of portal use have been demonstrated [15-19], and the OpenNotes movement [20] has promoted patient engagement through health records transparency by enabling patient access to provider notes. One of the implementation strategies that are critical to foster the adoption and sustained use of patient portals is an ongoing focus on user-centered design (UCD). This is often accomplished as part of periodic research studies; more timely and agile methods are needed to design and evaluate patient portals. Achieving significant growth in adoption and use requires agile evaluation methods to complement periodic formal research efforts
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