Abstract OT-22-01: Opportunities and lessons learned in using electronic health record patient portal (MyChart) for recruitment to the population-based WISDOM study

Abstract

Abstract Background: WISDOM is a preference-tolerant, pragmatic study comparing annual mammogram screening to personalized, risk-based breast screening in healthy women with a target accrual of 100,000. This sizable recruitment goal requires creative and broad-based strategies that are not typical for traditional clinical research. One of the recruitment methods is use of an electronic health record patient portal (Epic’s MyChart) to invite patients to participate in research. We tested various MyChart implementation strategies across WISDOM recruitment sites and report response rates, barriers and lessons learned. The study is registered on ClinicalTrials.gov, NCT02620852. Methods: Women aged 40-74 years with no history of breast cancer, DCIS, or double mastectomy can join the WISDOM Study online at wisdomstudy.org. Participants either elect to be randomized or self-select one of the study arms, the control (annual mammogram screening) arm or the treatment (personalized, risk-based breast screening) arm. All study steps can be completed electronically, with no requirement to travel to a study site. University of California, Los Angeles (UCLA) was the first WISDOM site to gain approval to use MyChart as a recruitment tool as part of the Clinical Translational Science Institute pilot in Spring 2018. The pilot was designed to demonstrate feasibility, patient response, and recruitment metrics. Following UCLA’s pilot, additional WISDOM sites received approval to use MyChart; however, implementation differed across sites based on local medical center leadership decisions. MyChart Implementation: As of July 2020, use of MyChart is ongoing at five of WISDOM’s six initial recruitment sites (UCLA, Sanford Health, UCSF, UCSD, UCI). Three sites (UCLA, Stanford, and UCSF) implemented MyChart broadly, and two sites (UCI and UCSD) are phasing in MyChart recruitment. UCLA and Sanford Health implemented MyChart recruitment through a centralized approach targeting all eligible patients and sending a MyChart invitation with a link to the study’s enrollment website. UCSF was approved to send WISDOM information on the MyChart portal, but the patients must opt in to learn more by outreach from a research coordinator. UCSD and UCI approaches are more limited requiring departmental or primary care provider approval for communications to be sent to patients. Results: MyChart enabled direct communication to a large number of potential study participants at UCLA and Sanford Health (UCLA 107,829, Sanford Health 86,684) during a 12-month period. The experiences of both sites were similar in that 50% of individuals read the MyChart message, 2.5-5% registered for additional information, and 1.5-2.5% consented to participate. UCSF’s implementation approach was similar with 8005 individuals invited, 6.6% indicating interest to participate, and 2.4% consenting. Although the number of consented participants represented a small portion of the total women consented to join the study to date, the recruitment rates from using MyChart were 2.5-10X higher compared to sites that did not use it or were in pilot phase. Participating sites saw 30%-50% increased recruitment rates during periods when MyChart messages were in use. Implementations at the departmental (UCSD) and primary care provider level (UCI) demonstrated similar trends (3.8% and 3% consented respectively), albeit with smaller samples. Conclusions: Use of electronic health record patient portal (MyChart) recruitment for the WISDOM Study increased enrollment rate by site and is a cost-effective approach to recruiting for large scale trials with broad eligibility criteria like the WISDOM Study. Citation Format: Antonio Petruse, Alyssa Rocha, Liliana Johansen, Neil Wenger, Mandy Che, Steele Fors, Hannah L Park, Janet Wernisch, Irene Acerbi, Allison S Fiscalini, Jasmin Hassam, Andrea LaCroix, Barbara Parker, Lisa Madlensky, Laura Van't Veer, Celia Kaplan, Hoda Anton-Culver, Andrea Kaster, Skye Stewart, Samrrah Rouf, Alexander Borowsky, Ian Hurley, Robert Hiatt, Vivian Lee, Diane Heditsian, Susie Brain, Olufunmilayo Olopade, Deepa Sheth, Laura Esserman, Wisdom Study and Athena Breast Health Network Investigators and Advocate Partners, Arash Naeim. Opportunities and lessons learned in using electronic health record patient portal (MyChart) for recruitment to the population-based WISDOM study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr OT-22-01.