Pilot Testing of a Patient Portal System among Patients with Type 2 Diabetes (T2D)
Purpose: The purpose of the project is to pilot messaging using the patient portal to patients with T2D and evaluate the effect of the messages on flu shot compliance, follow-up appointment rates, patient-provider communication, and patient satisfaction.
Background: Approximately 8.3% of the US population and 347 million people worldwide have Type 2 diabetes (T2D).T2D is a complicated disease, with many co-morbidities. The American Diabetes Association guideline specifically recommends that patients with T2D be cared for by a team, with a “collaborative therapeutic alliance” between the team, family, and with patient at the center of the care plan. To facilitate communication among patients and healthcare providers and encourage patient involvement in their care, the Centers for Medicare & Medicaid Services (CMS), instituted the Electronic Health Record (EHR) Incentive Program. Stage I and II of this program require that providers meet the Patient Electronic objective which gives patients access to their health information. The patient portal is an online database where patients can access their health information 24 hours a day. Patients are able to communicate with providers, see laboratory results, and access accurate medication lists. Stage I of the meaningful use involves registering patients, allowing them to access basic information, such as laboratory results and medications through the portal. Patient messaging to and from the provider is included in Stage II of meaningful use
Methods: The project is being implemented at a Federally Qualified Health Center in the southwest United States. The project facility implemented Stage I, registering their patients with the patient portal, at the beginning of 2014 and plans to start sending messages to their patients, which is Phase II, in January 2015. Following IRB approval, adult patients with T2D, who speak Spanish and/or English and who are registered with the patient portal will be recruited for the project. Each patient will receive a series of three messages through the patient portal: a reminder to get the flu shot, a reminder the patient is due for his or her three-month diabetic check-up, and the third message will ask if the patient has any questions for the provider about their recent visit. Following the three messages, a patient satisfaction survey will be sent through the patient portal to any patient who received any of the above messages. The electronic health record will be used to measure patient responses, flu shot compliance, and three-month appointment rates.
Implications for Practice: The patient portal is a new and emerging area, with high reimbursement dollars attached to its meaningful use. There is strong evidence that communication between patients and providers improves with use of the patient portal, thus strengthening the patient-provider relationship. Furthermore, use of the patient portal has the potential to help promote health and manage chronic diseases, such as T2D.