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Federally qualified health centers (FQHC) aim to improve cancer prevention by providing screening options and efforts to prevent harmful behavior. Patient portals are increasingly being used to deliver health promotion initiatives. However, little is known about patient portal activation rates in FQHC settings and the factors associated with activation. This study examined patient portal activation among FQHC patients and assessed correlations with demographic, clinical, and health service use variables. We analyzed electronic health record data from adults >18 years old with at least one appointment. Data were accessed from the electronic health records for patients seen between 1 September 2018 and 31 August 2022 (n = 40,852 patients). We used multivariate logistic regression models to examine the correlates of having an activated EPIC-supported MyChart patient portal account. One-third of patients had an activated MyChart portal account. Overall, 35% of patients with an activated account had read at least one portal message, 69% used the portal to schedule an appointment, and 90% viewed lab results. Demographic and clinical factors associated with activation included younger age, female sex, white race, English language, being partnered, privately insured, non-smoking, and diagnosed with a chronic disease. More frequent healthcare visits were also associated with an activated account. Whether or not a patient had an email address in the EHR yielded the strongest association with patient portal activation. Overall, 39% of patients did not have an email address; only 2% of those patients had activated their accounts, compared to 54% of those with an email address. Patient portal activation rates were modest and associated with demographic, clinical, and healthcare utilization factors. Patient portal usage to manage one's healthcare needs is increasing nationally. As such, FQHC clinics should enhance efforts to improve the uptake and usage of patient portals, including educational campaigns and eliminating email requirements for portal activation, to reinforce cancer prevention efforts.
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PURPOSE: To qualitatively examine barriers to patient portal use among low-income patients receiving health care services at a federally qualified health center (FQHC). METHODS: In-depth interviews were conducted with a volunteer sample of patients recruited from an FQHC. The interviews took 30-45 minutes. As participants arrived for each scheduled interview, written informed consent was obtained and participants completed a brief (5-10 minutes) self-administered survey. RESULTS: Participants (N =25) were primarily middle-aged (M = 53 years), Black (76%), and male (60%). Over 60% of patients had heard of MyChart, but only 40% were enrolled. Barriers to enrollment and use of MyChart were organized into individual, organizational, and structural levels. Providing low-literacy informational materials and enrollment assistance emerged as potential strategies for increasing MyChart use. CONCLUSION: Federally-qualified health centers serving low-income populations should enhance patient portal use by increasing awareness of the benefits of portals and assisting patients with enrollment.
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Portais do Paciente , Pessoa de Meia-Idade , Humanos , Masculino , Pobreza , Instalações de Saúde , Consentimento Livre e Esclarecido , PacientesRESUMO
Purpose: To describe the training, preliminary results, and lessons learned from using patient navigators to increase the enrollment of low-income patients in a health system-supported and electronic health record-linked patient portal. Methods: Patient navigators (n=4) were trained to assist patients in a federally qualified health center to enroll in and use patient portals. Patient navigators were stationed at 3 clinic locations. Data from the electronic health record system (Epic) were used to compare MyChart patient portal activation rates and use among patients for the 8 months before and after patient navigation services were offered. Results: Navigators offered 83% of eligible patients with activation assistance. Sixty-four percent of the patients (n=1062) offered MyChart enrollment assistance accepted help. Seventy-four percent of assisted patients with no prior MyChart enrollment activated their accounts during that clinic visit. The primary reason for declining MyChart assistance was a lack of access to or comfort with technology. Patient portal activation increased during the 8 months when navigators were at the clinics (51%) compared to the previous 8 months (44%). Most new users viewed lab results and read a message [χ2(1)=49.3, p<.001], with significant increases evident for African Americans [44% before, 49% during; χ2(1)=40.4, p<.001] and Latinx patients [52% before, 60% during; χ2(1)=6.15, p=.013]. Conclusion: Study results suggest that using patient navigators is feasible and beneficial for increasing patient enrollment in the Federally Qualified Health Centers context. However, patient-, clinic-, and system-level factors were identified as barriers and should be addressed in future research studies.
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Navegação de Pacientes , Portais do Paciente , Humanos , Navegação de Pacientes/organização & administração , Masculino , Feminino , Adulto , Pobreza , Registros Eletrônicos de Saúde , Pessoa de Meia-Idade , Negro ou Afro-AmericanoRESUMO
Learning Health Networks (LHN) improve the well-being of populations by aligning clinical care specialists, technology experts, patients and patient advocates, and other thought leaders for continuous improvement and seamless care delivery. A novel LHN focused on pediatric transplantation, the Starzl Network for Excellence in Pediatric Transplantation (SNEPT), convened its inaugural meeting in September 2018. Clinical care team representatives, patients, and patient families/advocates partnered to take part in educational sessions, pain point exercises, and project identification workshops. Participants discussed the global impact of transplant from both a population and individual perspective, identifying challenges and opportunities where the Starzl Network could work to improve outcomes at scale across a variety of transplant-related conditions.
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Sistema de Aprendizagem em Saúde , Transplante de Fígado/normas , Criança , Atenção à Saúde , Família , Humanos , Manejo da Dor , Medição da Dor , Pediatria/métodos , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde , Resultado do TratamentoRESUMO
This study describes the ways in which two African-American churches discuss adolescent sexual health topics. Six focus groups were conducted in two churches in Flint, Michigan, that reported no formal sexual health programming for their congregants. Three themes emerged to highlight the different perspectives about the role of churches in adolescent sexual decision-making and sexual health education: (1) churches as sources of sexual information, (2) churches as complex communities, and (3) recommendations for sexual education in churches. Participant responses suggest that churches can and should serve a resource for sexual health information. Implications for practice and research are discussed.