Patient Portal Messages Research Articles

Describing current use, barriers, and facilitators of patient portal messaging for research recruitment: Perspectives from study teams and patients at one institution

The electronic health record (EHR) and patient portal are used increasingly for clinical research, including patient portal recruitment messaging (PPRM). Use of PPRM has grown rapidly; however, best practices are still developing. In this study, we examined the use of PPRM at our institution and conducted qualitative interviews among study teams and patients to understand experiences and preferences for PPRM. We identified study teams that sent PPRMs and patients that received PPRMs in a 60-day period. We characterized these studies and patients, in addition to the patients' interactions with the PPRMs (e.g., viewed, responded). From these groups, we recruited study team members and patients for semi-structured interviews. A pragmatic qualitative inquiry framework was used by interviewers. Interviews were audio-recorded and analyzed using a rapid qualitative analysis exploratory approach. Across ten studies, 35,037 PPRMs were sent, 33% were viewed, and 17% were responded to. Interaction rates varied across demographic groups. Six study team members completed interviews and described PPRM as an efficient and helpful recruitment method. Twenty-eight patients completed interviews. They were supportive of receiving PPRMs, particularly when the PPRM was relevant to their health. Patients indicated that providing more information in the PPRM would be helpful, in addition to options to set personalized preferences. PPRM is an efficient recruitment method for study teams and is acceptable to patients. Engagement with PPRMs varies across demographic groups, which should be considered during recruitment planning. Additional research is needed to evaluate and implement recommended changes by study teams and patients.

1976. Using a Patient Portal as a Recruitment Tool to Diversify the Pool of Participants in COVID-19 Vaccine Clinical Trials

Abstract Background Because the COVID-19 pandemic disproportionately affected racial/ethnic minorities in the US, there was a push to ensure diversity in COVID-19 vaccine clinical trials. Historically, minority groups have been underrepresented in research. We assessed the feasibility of recruiting racial/ethnic minorities through an electronic health record (EHR) patient portal. Methods The UPenn Health System EHR was used to identify individuals ages 40 and older, living in zip codes with high rates of SARS-CoV-2 test positivity, with a risk factor associated with severe COVID-19 disease. Eligible individuals with an activated patient portal account were sent a message inviting them to participate in the COVID-19 vaccine clinical trial. A follow-up phone call was made to those who did not respond or declined, and reasons for or against participation were coded to extract themes. Results In August 2020, a total of 13,779 patients fit the inclusion criteria, of which 5,614 (40.7%) had an activated patient portal account and were invited to participate. The majority, 5,426 (96.7%), identified as black, and 73 (1.3%) identified as Hispanic/Latinx. Only 301 (5.4%) of messaged individuals responded. Among respondents, 55 of 206 (26.7%) blacks, 5 of 7 (71.4%) Hispanic/Latinx, and 50 of 76 (65.8%) whites expressed interest. Among the 115 respondents who expressed interest, 24 agreed to a screening visit, and 9 were ultimately enrolled in the trial, which consisted of 6 black, 3 white, and 1 Hispanic/Latinx individual. During phone outreach to those who did not respond and those who declined, common reasons for declining included underlying health conditions, fears of an unproven vaccine, not wanting to be experimented upon, the rapid speed of vaccine development, and the lack of time to participate in a trial. Patient portal response rates by race/ethnicity Conclusion Because of low rates of patient portal account activation and use, compounded with vaccine hesitancy, recruitment of racial/ethnic minorities into COVID-19 vaccine clinical trials through patient portal messaging yielded a small number of participants. Strategies to increase use of the patient portal combined with approaches to address concerns of trial participation should be considered to increase enrollment of racially/ethnically diverse groups into vaccine clinical trials. Disclosures All Authors: No reported disclosures.

Identifying Nonpatient Authors of Patient Portal Secure Messages in Oncology: A Proof-of-Concept Demonstration of Natural Language Processing Methods.

Patient portal secure messages are not always authored by the patient account holder. Understanding who authored the message is particularly important in an oncology setting where symptom reporting is crucial to patient treatment. Natural language processing has the potential to detect messages not authored by the patient automatically. Patient portal secure messages from the Memorial Sloan Kettering Cancer Center were retrieved and manually annotated as a predicted unregistered proxy (ie, not written by the patient) or a presumed patient. After randomly splitting the annotated messages into training and test sets in a 70:30 ratio, a bag-of-words approach was used to extract features and then a Least Absolute Shrinkage and Selection Operator (LASSO) model was trained and used for classification. Portal secure messages (n = 2,000) were randomly selected from unique patient accounts and manually annotated. We excluded 335 messages from the data set as the annotators could not determine if they were written by a patient or proxy. Using the remaining 1,665 messages, a LASSO model was developed that achieved an area under the curve of 0.932 and an area under the precision recall curve of 0.748. The sensitivity and specificity related to classifying true-positive cases (predicted unregistered proxy-authored messages) and true negatives (presumed patient-authored messages) were 0.681 and 0.960, respectively. Our work demonstrates the feasibility of using unstructured, heterogenous patient portal secure messages to determine portal secure message authorship. Identifying patient authorship in real time can improve patient portal account security and can be used to improve the quality of the information extracted from the patient portal, such as patient-reported outcomes.

Effect of Electronic Outreach Using Patient Portal Messages on Well Child Care Visit Completion

Outreach messages to patients overdue for well child care (WCC) can be delivered different ways (ie, telephone calls and text messages). Use of electronic health record patient portals is increasingly common but their effectiveness is uncertain. To determine the effectiveness of patient portal outreach messages, with and without the date of the last WCC, on the scheduling and completion of WCC visits and completion of vaccinations. An intention-to-treat, multigroup, randomized clinical trial was conducted at 3 academic primary care practices from July 30 to October 4, 2021. The population included predominantly non-Hispanic Black, low-income children (age, 6-17 years) whose parent had an active portal account. Participants were randomized to the standard message, tailored message, or no message (control) group. Two messages were delivered to those in the message groups. Outcomes included WCC visit scheduled within 2 weeks of the first intervention message, WCC visit completed within 8 weeks (primary outcome), and receipt of COVID-19 vaccine within 8 weeks. Nine hundred forty-five patients participated (mean [SD] age, 9.9 [3.3] years, 493 [52.2%] girls, 590 [62.4%] non-Hispanic Black, 807 [85.4%] publicly insured). Scheduling rates were 18.4% in the standard message group (adjusted risk ratio [aRR], 1.97; 95% CI, 1.32-2.84) and 14.9% in the tailored message group (aRR, 1.57; 95% CI, 1.02-2.34) compared with the control group (9.5%). Well child care visit completion rates were 24.1% in the standard message group (aRR, 1.92; 95% CI, 1.38-2.60) and 19.4% in the tailored message group (aRR, 1.52; 95% CI, 1.06-2.13) compared with the control group (12.7%). Among eligible children, rates of receiving the COVID-19 vaccine were 16.7% in the standard message group compared with 4.8% in the tailored message (aRR, 3.41; 95% CI, 1.14-9.58) and 3.7% in the control groups (aRR, 4.84; 95% CI, 1.44-15.12). In this randomized clinical trial, outreach messages delivered via electronic health record patient portals increased the rates of scheduling and completing WCC visits and receiving the COVID-19 vaccine, providing a useful tool to help restore WCC in populations whose care was delayed during the pandemic. ClinicalTrials.gov Identifier: NCT04994691.

Abstract 13780: Sociodemographic Differences in Patient Portal Research Recruitment of Older Adults With Heart Failure

Introduction: Innovative recruitment strategies such as patient portal messaging (PPM) hold promise for high yield, low-cost recruitment of heart failure (HF) patients for research studies but may impact the diversity of the sample. We aimed to examine strategies used to recruit older adults with advanced HF during COVID-19 in an ongoing prospective palliative care research study. Methods: We used three recruitment strategies including the traditional in-person HF clinic screening or provider referral, and a more innovative direct-to-patient recruitment approach using EHR patient portal messaging (PPM) or email. We compared characteristics of participants recruited via PPM/email and traditional in-person recruitment strategies using chi-squared and t-tests. We used multiple logistic regression to examine associations between participant characteristics and recruitment type. Results: Most participants were recruited through PPM or email (86%, n=247) over 10 months and the remaining participants were recruited through provider referral or in-person recruitment at the heart failure clinic over 6 months (14%, n=40). Among our sample of 287 participants, 67% (n=201) were White, 28% (n=84) were Black, and the remaining 5% (n=13) were Asian, American Indian, or Alaska Native or identify with a non-listed race. The mean age was 68 years old. There was no significant difference in recruitment type by age, gender, or financial strain. There was a significant difference in recruitment type by race and education level. In a multiple logistic regression adjusting for age, gender, and financial strain, Black participants had a lower odds of PPM recruitment than white participants (OR 0.15, p<0.001). Additionally, those with higher education showed higher odds of PPM/email recruitment (OR 4.2 p = 0.001). Conclusions: In this study, PPM was an efficient recruitment strategy with higher odds of recruiting participants of White race and higher education compared to traditional recruitment strategies. Use of both traditional and more innovative direct-to-patient recruitment strategies may promote a more diverse study sample.

Creation of an Operational Dashboard to Document Implementation of 4M’s into Primary Care in a Geriatric Patient-Centered Medical Home

Many health systems have joined the Age-Friendly Health Systems movement to provide every older adult safe, high-quality care aligned with what matters most. Becoming an Age-Friendly Health System means that hospitals and health care systems reliably use a set of evidence-based practices known as the “4M’s” – What Matters, Medication, Mentation, and Mobility – to provide care for older, disabled and medically complex patients across all care settings. Implementing the Institute for Healthcare Improvement’s (IHI) 4M’s Age-Friendly principles into primary care is challenging because there is no best practice to identify documentation of delivery. Leveraging the electronic health record (EHR) may automate this process. Age-Friendly principles for primary care were discussed at IHI peer coaching webinars, and PDSA cycles employed among clinic staff to define each of the 4M’s for the Vanderbilt Geriatric Practice: 1) Mentation – Mini-COG and PHQ2 extracted from nursing intake, 2) Medication – extracted from medication review, provider reconciliation, 3) Mobility – extracted from activities of daily living (ADL) mobility questions in nursing intake, and 4) What Matters Most – identifying patient portal messages. A dashboard within our EPIC electronic health record (EHR) was built based on these identified fields, allowing clinician drill-down to display more detail as needed. An operational dashboard for an EHR has potential to help inform clinician delivery of 4M’s care in the primary care setting.

A novel household-based patient outreach pilot program to boost late-season influenza vaccination rates during the COVID-19 pandemic.

The objective of this study was to test a novel household-based approach to improve late-season influenza vaccine uptake during the 2020-2021 season, using Epic's MyChart patient portal messages and/or interactive voice response telephone calls. This study was a non-blinded, quality improvement program using a block randomized design conducted among patients from Reliant Medical Group clinics residing in a traditional household (≥2 individuals clinically active in the Reliant system living at the same address). Households were randomized 1:1:1 into intervention arms: non-tailored communication (messaging based on CDC's seasonal influenza vaccination campaign), tailored communication (comprehensive communication including reinforcement of the importance of influenza vaccination for high-risk individuals), and standard-of-care control. Influenza vaccination during the program was captured via medical records, and the odds of vaccination among communication arms versus the control arm were assessed. A survey assessing influenza vaccination drivers was administered using MyChart. Influenza vaccination increased by 3.3% during the program period, and no significant differences in vaccination were observed in intervention arms relative to the control arm. Study operationalization faced substantial challenges related to the concurrent COVID-19 pandemic. Compared with vaccinated survey respondents, unvaccinated respondents less frequently reported receiving a recommendation for influenza vaccination from their healthcare provider (15.8% vs. 42.3%, p < 0.001) or awareness that vaccination could protect themselves and higher risk contacts (82.3% vs. 92.6%, p < 0.001). No significant effects of the interventions were observed. Survey results highlighted the importance of healthcare provider recommendations and the need for increased education around the benefits of vaccination.

A comparative cohort study of gastrointestinal oncology patients: Impact of a shift to telehealth on delivery of interprofessional cancer care

Early studies of oncology visits performed via telehealth demonstrate patient and provider satisfaction; however, understanding of the impact of telehealth on clinic workflows is limited. The incorporation of telehealth visits into an interprofessional model of oncology care was evaluated to assess for changes in care delivery and patient engagement. New patients with a gastrointestinal cancer diagnosis who were actively undergoing treatment and followed for at least three months were divided into two cohorts based on telehealth utilization. Individual patient charts were reviewed by touchpoint, consisting of in-person visits, telehealth visits, phone calls, and patient portal messages. A total of 28 patient charts were analyzed, 11 pre-telehealth conventional care patients, and 17 telehealth patients. Telehealth cohort patients demonstrated an increased average number of total touchpoints when compared to the pre-telehealth cohort (p-value = 0.008) and had an increased number of patient portal and phone call touchpoints (p-value = 0.00 and 0.002). Telehealth provided more interactions between patients and providers demonstrating increased connectivity between a patient and their care team throughout their complex cancer journey. Clinic workflows may need to adjust to account for the increased demand of unscheduled patient interactions.

Identification of Transportation Barriers in Patient Portal Messages via Deep Semantic Embeddings and Clustering.

Patient portals have been widely used by patients to enable timely communications with their providers via secure messaging for various issues including transportation barriers. The large volume of portal messages offers an invaluable opportunity for studying transportation barriers reported by patients. In this work, we explored the feasibility of cutting-edge deep learning techniques for identifying transportation issues mentioned in patient portal messages with deep semantic embeddings. The successful creation of annotated corpus and identification of 7 transportation issues showed the feasibility of this strategy. The developed annotated corpus could aid in developing an artificial intelligence tool to automatically identify transportation issues from millions of patient portal messages. The identified specific transportation issues and the analysis of patient demographics could shed light on how to reduce transportation gaps for patients.

Patient Portal Messaging for Asynchronous Virtual Care During the COVID-19 Pandemic: Retrospective Analysis.

BackgroundDuring the COVID-19 pandemic, patient portals and their message platforms allowed remote access to health care. Utilization patterns in patient messaging during the COVID-19 crisis have not been studied thoroughly. In this work, we propose characterizing patients and their use of asynchronous virtual care for COVID-19 via a retrospective analysis of patient portal messages.ObjectiveThis study aimed to perform a retrospective analysis of portal messages to probe asynchronous patient responses to the COVID-19 crisis.MethodsWe collected over 2 million patient-generated messages (PGMs) at Mayo Clinic during February 1 to August 31, 2020. We analyzed descriptive statistics on PGMs related to COVID-19 and incorporated patients’ sociodemographic factors into the analysis. We analyzed the PGMs on COVID-19 in terms of COVID-19–related care (eg, COVID-19 symptom self-assessment and COVID-19 tests and results) and other health issues (eg, appointment cancellation, anxiety, and depression).ResultsThe majority of PGMs on COVID-19 pertained to COVID-19 symptom self-assessment (42.50%) and COVID-19 tests and results (30.84%). The PGMs related to COVID-19 symptom self-assessment and COVID-19 test results had dynamic patterns and peaks similar to the newly confirmed cases in the United States and in Minnesota. The trend of PGMs related to COVID-19 care plans paralleled trends in newly hospitalized cases and deaths. After an initial peak in March, the PGMs on issues such as appointment cancellations and anxiety regarding COVID-19 displayed a declining trend. The majority of message senders were 30-64 years old, married, female, White, or urban residents. This majority was an even higher proportion among patients who sent portal messages on COVID-19.ConclusionsDuring the COVID-19 pandemic, patients increased portal messaging utilization to address health care issues about COVID-19 (in particular, symptom self-assessment and tests and results). Trends in message usage closely followed national trends in new cases and hospitalizations. There is a wide disparity for minority and rural populations in the use of PGMs for addressing the COVID-19 crisis.

Midwest rural-urban disparities in use of patient online services for COVID-19.

PurposeRural populations are disproportionately affected by the COVID‐19 pandemic. We characterized urban‐rural disparities in patient portal messaging utilization for COVID‐19, and, of those who used the portal during its early stage in the Midwest.MethodsWe collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient‐generated messages (PGMs) on COVID‐19 by urban‐rural locality and incorporated patients’ sociodemographic factors into the analysis.FindingsThe urban‐rural ratio of portal users, message senders, and COVID‐19 message senders was 1.18, 1.31, and 1.79, indicating greater use among urban patients. The urban‐rural ratio (1.69) of PGMs on COVID‐19 was higher than that (1.43) of general PGMs. The urban‐rural ratios of messaging were 1.72‐1.85 for COVID‐19‐related care and 1.43‐1.66 for other health care issues on COVID‐19. Compared with urban patients, rural patients sent fewer messages for COVID‐19 diagnosis and treatment but more messages for other reasons related to COVID‐19‐related health care (eg, isolation and anxiety). The frequent senders of COVID‐19‐related messages among rural patients were 40+ years old, women, married, and White.ConclusionsIn this Midwest health system, rural patients were less likely to use patient online services during a pandemic and their reasons for its use differ from urban patients. Results suggest opportunities for increasing equity in rural patient engagement in patient portals (in particular, minority populations) for COVID‐19. Public health intervention strategies could target reasons why rural patients might seek health care in a pandemic, such as social isolation and anxiety.

Targeted Electronic Patient Portal Messaging Increases Hepatitis C Virus Screening in Primary Care: a Randomized Study.

Electronic health record (EHR) tools such as direct-to-patient messaging and automated lab orders are effective at improving uptake of preventive health measures. It is unknown if patient engagement in primary care impacts efficacy of such messaging. To determine whether more engaged patients, defined as those who have an upcoming visit scheduled, are more likely to respond to a direct-to-patient message with an automated lab order for hepatitis C virus (HCV) screening. Randomized trial PARTICIPANTS: One thousand six hundred randomly selected Stanford Primary Care patients, 800 with an upcoming visit within 6 months and 800 without, born between 1945 and 1965 who were due for HCV screening. Each group was randomly divided into cohorts of 400 subjects each. Subjects were followed for 1 year. One 400 subject cohort in each group received a direct-to-patient message through the EHR portal with HCV antibody lab order. The EHR was queried on a monthly basis for 6 months after the intervention to monitor which subjects completed HCV screening. For any subjects screened positive for HCV, follow-up through the cascade of HCV care was monitored, and if needed, scheduled by the study team. Of 1600 subjects, 538 (34%) completed HCV screening. In the stratum without an upcoming appointment, 18% in the control group completed screening compared to 26% in intervention group (p<0.01). Similarly, in the stratum with an upcoming appointment, 34% in the control group completed screening compared to 58% in the intervention group (p<0.01). Direct-to-patient messaging coupled with automated lab orders improved HCV screening rates compared to standard of care, particularly in more engaged patients. Including this intervention in primary care can maximize screening with each visit, which is particularly valuable in times when physical throughput in the healthcare system may be low.

Strategies and lessons learned from a longitudinal study to maximize recruitment in the midst of a global pandemic

The COVID-19 pandemic disrupted many usual processes for recruiting and enrolling research participants. We present our experience with electronic recruitment in a survey study investigating the impact of the COVID-19 pandemic on mental health. Adults (≥18 years) in communities served by Baylor Scott and White Health (BSWH) were recruited via patient portal messages sent to BSWH patients with confirmed/suspected COVID-19 as part of the “COVID-19 Digital Care Journey”; BSWH social media posts; other media; referral from other BSWH COVID-19 studies; and internal BSWH communications. Of 1279 enrolled participants, 996 (77.87%) were recruited via the Digital Care Journey and 124 (9.7%) via internal communications. The remaining strategies contributed <5% each. Social media and internal communications recruited larger proportions of those aged 18 to 34 and those with advanced degrees; other media, more racially diverse participants; and the Digital Care Journey and referral from other studies, predominantly participants positive for COVID-19. In terms of volume, the COVID-19 Digital Care Journey was the most successful strategy, particularly for individuals who had COVID-19. However, its dominance contributed to the overrepresentation of white, educated, and female participants. Thus, supplemental strategies to reach individuals not enrolled/engaging with the portal are necessary to achieve representativeness.

Telehealth application in Sudan: requirements and potential benefits.

Telehealth (TH) is defined as the entire spectrum of activities used to deliver care remotely. It could either be provider-to-patient or provider-to-provider communications. TH can take place synchronously (via telephone and video), asynchronously (via patient portal messages, e-consults), and through virtual agents (chat) and wearable devices. It has been used to support access to specialised medical advice in remote areas in many countries all over the world. We discuss the potential use of TH Clinics in Sudan and propose guidance for establishing such services. The current pandemic of SARS-COVID-19 has increased the pressure on most health systems. This has challenged and urged for significant changes in the way we provide health care for both COVID and non-COVID cases. There is a great potential for improvement in services in many countries including Sudan with the use of TH.

Portal Message Language Use Prior to Suicide, Suicide Attempts, and Hospitalization for Depression.

Introduction: Previous research suggests patients may be willing to communicate serious psychiatric concerns through patient portals. Methods: Retrospective chart review of portal messages sent by patients who had an emergency department (ED) visit or hospitalization for depression, self-harm, or suicidality or had a completed suicide (cases) was reviewed for content that was suggestive of depression or self-harm and language indicating emotional distress. Comparison with a randomly selected group (controls) was performed. Results: During the study period 420 messages were sent by 149 patients within 30 days of death by suicide, ED visit, and/or hospitalization related to depression, suicidality, or suicide attempt. Thirteen patients died by suicide but only 23% (3 of 13) sent one or more portal messages within 30 days before their death. None mentioned thoughts of self-harm. There were 271 messages sent by patients who were hospitalized, 142 messages by those who presented to the ED, and 56 messages patients who attempted suicide. Patient messages from cases were more likely than messages from controls to convey a depressed mood (17.1% vs. 3.1%, odds ratio 6.5; 95% confidence interval 3.6-11.9, p < 0.0001), thoughts of suicide or self-harm (4.8% vs. 0% p < 0.0001), or have a distressed tone (24.0% vs. 1.7%, odds ratio 18.7; 95% confidence interval 8.6-41, p < 0.0001). Conclusions: Patient portal messages from patients with subsequent hospitalizations for depression and suicidality do report thoughts of depression, distress, and thoughts of self-harm. However, portal use before completed suicide was not helpful at identifying at-risk patients although total numbers were small.

A retrospective review of unreimbursed medical care provided through electronic patient portals in dermatologic surgery

To the Editor: Patient portals, based on electronic medical records, allow patients to view medical records and securely message their practitioners. Direct messaging between patients and health care teams improves patient satisfaction.1 However, the number of patient-initiated messages has increased over time in dermatology and other fields.2,3 Although the increasing workload can be optimized, it cannot be eradicated.4 Patient portal messaging will likely increase further with the implementation of the 21st Century Cures Act, which allows patients immediate access to their health records.

S3268 Development and Implementation of EGID Partners: A Global, Online, Patient-Centric Research Platform

Introduction: Eosinophilic GI diseases (EGIDs) include eosinophilic esophagitis (EoE), gastritis (EG), gastroenteritis (EGE), and colitis (EC) and represent a substantial burden to patients and caregivers. We aimed to develop and implement a global, online, patient-centric research platform to provide a foundation for studies of EGIDs. Methods: Patient advocacy groups (PAGs) and EGID researchers collaborated to design EGID Partners (egidpartners.org) and enroll both cases and controls. The overall structure included baseline surveys followed by updates every 6 months. At follow-up, new surveys could also be deployed. There were 8 possible pathways: EoE adults (≥18 years); non-EoE EGID adults; adults with both EoE and EGID; non-EGID adult controls; and these same groups but for caregivers of children < 18 years of age. Recruitment is rolling, with baseline surveys including demographics, disease and medical history, treatment history, and validated patient-reported outcomes (PROs) for symptoms and quality of life. Baseline surveys also included assessment of early life exposures and patient-level costs, health utilization, and burden of disease. A multifaceted recruitment plan was instituted with informational emails and social media campaigns from PAGs, directed messages to EGID patients through medical record patient portals, webinars, and by publicizing the platform among physicians and at meetings. Results: EGID Partners was launched in October, 2020 (Fig. 1A). To date, 360 subjects (Partners) have joined, including 330 cases and 30 controls; 290 were adults and 70 were caregivers. There were 256 with EoE, 7 with EG, 14 with EGE, 5 with EC, and 78 with overlapping EGIDs (38 of whom had esophageal involvement). Partners have joined from 14 countries, with most from the US (295, from 36 states) and Australia (35). Recruitment increased steadily, but with notable spikes after webinars and patient portal messages (Fig. 1B). Six months after launch, a new follow-up survey was deployed to assess selected non-GI symptoms in EGID patients. Conclusion: We successfully developed and implemented EGID Partners, a patient-centric, online research platform. Despite the rarity of these diseases, patients from around the world and across all EGID types were recruited within a short period of time. The goal is for EGID Partners to expand into a patient-powered research network, with future research informed by patient, PAG, and researcher input.Figure 1.: Development and recruitment for EGID Partners. The home page (A) and recruitment trends (B) are displayed.

Improving Efficiency and Quality of Patient Portal Messaging in an Academic Dermatologic Surgery Clinic.

Improving Efficiency and Quality of Patient Portal Messaging in an Academic Dermatologic Surgery Clinic.

Impact of Patient Portal Messaging Reminders with Self-Scheduling Option on Influenza Vaccination Rates: a Prospective, Randomized Trial.

BackgroundPatient portal messages have been used in a variety of ways to facilitate improved communication between provider and patient. These platforms have shown promise in many ways for improving various health outcomes and overall communication between patient and provider.ObjectiveAssess the impact of automated portal reminder messages and self-scheduling options on increasing rates of annual influenza vaccination.DesignThis is a prospective, randomized, controlled study.ParticipantsAll patients who receive their primary care through an ambulatory primary care clinic at a large, multidisciplinary, academic health center.InterventionsOne group of patients received a portal message reminder to undergo influenza vaccination. A second group received the same message with instructions to self-schedule the vaccination appointment. A third group received no portal message (control).Main MeasuresRates of influenza vaccination in each group for previously unvaccinated patients in the 2019−2020 influenza season.Key ResultsFor the group receiving the message with self-scheduling option (n=5408), the in-study vaccination rate was significantly greater than the group receiving no message (n=5621) (15.7% vs. 13.5%; p=0.002). For the group receiving a message alone (without self-scheduling) (n=5699), the in-study vaccination rate was significantly greater than the group receiving no message (15.1% vs. 13.5%; p=0.01). There was no significant difference in vaccination rate between the two intervention groups receiving messages (15.7% vs. 15.1%; p=0.549).ConclusionsPortal messaging reminders increase annual influenza vaccination rates, but the addition of a self-scheduling option did not further increase rates.Key Wordsvaccination patient portal messaging influenza

Patient Recruitment Into a Multicenter Clinical Cohort Linking Electronic Health Records From 5 Health Systems: Cross-sectional Analysis

BackgroundThere is growing interest in identifying and recruiting research participants from health systems using electronic health records (EHRs). However, few studies have described the practical aspects of the recruitment process or compared electronic recruitment methods to in-person recruitment, particularly across health systems.ObjectiveThe objective of this study was to describe the steps and efficiency of the recruitment process and participant characteristics by recruitment strategy.MethodsEHR-based eligibility criteria included being an adult patient engaged in outpatient primary or bariatric surgery care at one of 5 health systems in the PaTH Clinical Research Network and having ≥2 weight measurements and 1 height measurement recorded in their EHR within the last 5 years. Recruitment strategies varied by site and included one or more of the following methods: (1) in-person recruitment by study staff from clinical sites, (2) US postal mail recruitment letters, (3) secure email, and (4) direct EHR recruitment through secure patient web portals. We used descriptive statistics to evaluate participant characteristics and proportion of patients recruited (ie, efficiency) by modality.ResultsThe total number of eligible patients from the 5 health systems was 5,051,187. Of these, 40,048 (0.8%) were invited to enter an EHR-based cohort study and 1085 were enrolled. Recruitment efficiency was highest for in-person recruitment (33.5%), followed by electronic messaging (2.9%), including email (2.9%) and EHR patient portal messages (2.9%). Overall, 779 (65.7%) patients were enrolled through electronic messaging, which also showed greater rates of recruitment of Black patients compared with the other strategies.ConclusionsWe recruited a total of 1085 patients from primary care and bariatric surgery settings using 4 recruitment strategies. The recruitment efficiency was 2.9% for email and EHR patient portals, with the majority of participants recruited electronically. This study can inform the design of future research studies using EHR-based recruitment.