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Personal Patient Portal Messages Can Support Self-Management

Patient portals that sent individualized self-management cues were usable and relevant to patient needs.

Patient portal messages should contain self-management instructions.

Source: Thinkstock

By Sara Heath

- Patient portals and personal health IT devices are effective for pushing individualized self-management information to patients, according to a study published in the journal eGEMS.

Adriana Arcia, study author and researcher at the Columbia University School of Nursing, found that patient portals are effective at using individual patient information to target specific educational materials that aid in pregnancy management.

“Pregnancy is a time of high information need as maternity care clients manage the health of their changing bodies and look ahead to birth and parenting,” Arcia wrote.

However, ensuring pregnant patients have the correct information to manage their own care is difficult. Patients are not always aware of what they don’t know, and therefore have a hard time finding educational materials on their own.

“Information needs during the maternity care episode extend beyond those identified by the client; clinicians and health educators must provide anticipatory guidance to cover material that the client would find useful but might not seek out independently,” Arcia explained.

READ MORE: How Can Providers Boost Self-Management for Chronically Ill Patients?

Arcia tested patient portals as one method for delivering these anticipatory educational messages. A small sample of pregnant women – 16 recruits and 12 ultimate participants – used a portal called Maternity Information Access Point (MIAP). Participants had to be fluent in either English or Spanish, at least 35 weeks pregnant, and at least 18 years old.

The portal used patient health information to target weekly push emails that catered to individual patient needs. The portal also contained a library of information patients could browse through or find information using a direct search bar.

After four weeks of use, Arcia and her research team conducted qualitative interviews and focus groups with the patients to determine their preferences for the educational messages. Participants gave MIAP high satisfaction and usability ratings: 4.3 and 4.7 points out of five, respectively.

Specifically, patients reported satisfaction with the weekly emails, saying that they valued the timeliness and specificity of information.

Patients were more likely to read and use the information shared with them via patient portal message, Arcia observed. Rarely did patients search the portal for specific information. Instead, patients browsed the information or consulted the articles pushed to them through a secure message.

READ MORE: How mHealth Technology Supports Patient Engagement Strategies

Additionally, patient portal logins matched patient-reported enthusiasm for healthcare research. One patient reported that her clinician gave her all of the information she felt she needed and the patient never logged into the portal.

Another patient called herself a “research nut,” and was the most active patient portal user in the study.

“Our interpretation of this finding is that MIAP provided an opportunity for women to meet their information needs to the extent that they perceived them but without being intrusive,” Arcia said.

Barriers included the password protection on the patient portal and portal usability.

Portal usability barriers will be phased out over time as more individuals are native technology users, Arcia asserted. In the interim, she suggests doctors walk their patients through the tool the first few weeks following introduction.

READ MORE: Patient Portal Use Lagging Despite Strong Provider Support

Patients also expressed frustration that the patient information portal was password protected. This feature was cumbersome for patients who reported forgetting their passwords frequently.

Federal mandates required Arcia to put password protections on the portal because the website and adjoining portals stored protected health information (PHI).

In the future, Arcia hopes to see technologies and HIPAA rules accept fingerprint scans as passwords. Until then, platforms should explain to patients the rationale behind the password, and the risks patients face should the patient portal not be password protected.

These results have implications beyond pregnancy, Arcia pointed out. Individualized educational messages pushed through the patient portal can be useful for any patient managing a chronic illness, including diabetes or heart disease.

EHR-informed educational messages could also help patients during post-acute follow-up care, Arcia said in a statement.

“Based on these results, we recommend exploring the use of other pieces of information from the EHR to push information to patients,” she explained. “For example, if the procedure codes in the EHR indicate that a patient just got stitches, they could automatically receive instructions on how to care for their wound.”

Healthcare professionals should conduct more research into implementing these tools for other patients who are not managing pregnancy, Arcia said.

“It is possible that there are other situations in which patients would appreciate receiving pushed content based upon one or more data elements in the EHR,” she concluded in her paper. “We envision that this popular feature could be extended to other data elements within the EHR to support clients’ learning needs for a variety of health conditions.”