The Use of Navigators to Increase Patient Portal Enrollment among Patients in a Federally Qualified Health Care System.

Abstract

To describe the training, preliminary results, and lessons learned from using patient navigators to increase the enrollment of low-income patients in a health system-supported and electronic health record-linked patient portal. Patient navigators (n=4) were trained to assist patients in a federally qualified health center to enroll in and use patient portals. Patient navigators were stationed at 3 clinic locations. Data from the electronic health record system (Epic) were used to compare MyChart patient portal activation rates and use among patients for the 8 months before and after patient navigation services were offered. Navigators offered 83% of eligible patients with activation assistance. Sixty-four percent of the patients (n=1062) offered MyChart enrollment assistance accepted help. Seventy-four percent of assisted patients with no prior MyChart enrollment activated their accounts during that clinic visit. The primary reason for declining MyChart assistance was a lack of access to or comfort with technology. Patient portal activation increased during the 8 months when navigators were at the clinics (51%) compared to the previous 8 months (44%). Most new users viewed lab results and read a message [χ2(1)=49.3, p<.001], with significant increases evident for African Americans [44% before, 49% during; χ2(1)=40.4, p<.001] and Latinx patients [52% before, 60% during; χ2(1)=6.15, p=.013]. Study results suggest that using patient navigators is feasible and beneficial for increasing patient enrollment in the Federally Qualified Health Centers context. However, patient-, clinic-, and system-level factors were identified as barriers and should be addressed in future research studies.