An RCT of an Online Training for Vulnerable Patients to Use an Online Patient Portal Website

Not Applicable

Completed

• Conditions: Electronic Health Records; Chronic Disease; Health Literacy
• Interventions: Behavioral: Take-home online training; Behavioral: In-person online training

• Registration Number: NCT03354000
• Lead Sponsor: University of California, San Francisco

Brief Summary

Online patient portals are becoming ubiquitous in the US. Previous research has documented substantial usability barriers, especially among patients with limited health literacy. This pilot randomized pilot trial had the goal of determining the effectiveness of an in-person training with a scalable online video-based training program to increase portal use among patients in a safety net healthcare setting.

Detailed Description

The intervention in this study was a patient portal training curriculum with simple instructions and 11 how-to videos for accessing features of an online patient portal. Using a deeply participatory approach, this curriculum was created in consultation with a patient advisory board from the San Francisco Health Network, a local Medicaid health plan. From June until October 2016, 93 patients with 1 or more chronic diseases were randomized to receive either: 1) an in-person tutorial with a trained research assistant versus 2) a link to view the videos on their own. The primary outcome was portal log-in (yes/no) between 3 and 6 months post-training, assessed through a portal administrative dashboard within the EHR. Secondary outcome included baseline and follow-up survey measures on participants' perceptions of the portal use and their care, as well as views of the web-based lessons.

Study Timeline

• Study Start: 2015-08-01
• Primary Completion: 2017-07-31
• Study First Submitted: 2017-11-09
• Study First Submitted QC: 2017-11-21
• Study First Posted: 2017-11-27
• Study Completion: 2018-07-31
• Status Verified: 2019-04
• Last Update Submitted: 2019-04-17
• Last Update Posted: 2019-04-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 93

Inclusion Criteria

• English-speaking as portal is only available in English
• diagnosed with at least one chronic condition

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Exclusion Criteria

• cognitive impairment
• visual impairment
• severe mental health conditions
• any circumstances that would make participation in the study difficult
• no previous email use
• self-reported usage of MYSFHEALTH

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Take-home online training	Take-home online training	Participants received a link to access the online tutorial videos on their own.
In-person online training	In-person online training	Participants received an in-person tutorial of how to use the patient portal website with a trained research assistant.

Primary Outcome Measures

Name	Time	Method
Portal log-ins	3-6 months post-training	Logging into the portal website in the 3-6 months post-training (yes/no)

Secondary Outcome Measures

Name	Time	Method
eHealth Literacy	3-6 months post-training	The eHEALS is a measure of eHealth literacy developed to measure consumers' combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. eHEALS was measured at baseline and follow-up via surveys
Portal sign-up	3-6 months post-training	Initiating sign-up process for the portal website (yes/no), as pulled from EHR chart review
Digital literacy skills	3-6 months post-training	Confidence in having skills to be able to use online portal website (scored from 1 to 0), as self-reported via baseline and follow-up surveys