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

Engaging Diverse Patients in Using an Online Patient Portal

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.

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.

Inclusion Criteria:

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

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