Policies and procedures governing patient portal use at an Academic Medical Center

Abstract

Background and Objective Patient portal use has increased over the last two decades in response to consumer demand and government regulation. Despite growing adoption, few guidelines exist to direct successful implementation and governance. We describe the policies and procedures that have governed over a decade of continuous My Health at Vanderbilt (MHAV) patient portal use. Methods We examined MHAV usage data between May 2007 and November 2017. We classified patient portal activity into eight functional categories: Appointment, Billing, Document Access, Genetics, Health Result, Immunization, Medication, and Messaging. We describe our operating policies and measure portal uptake, patient account activity, and function use over time. Results By the end of the study period, there were 375 517 registered accounts. Policies made MHAV available to competent adults and adolescents 13 and over. Patients signed up for a limited access account online, which could be upgraded to a full-access account after identity verification. Patients could assign proxy accounts to family and caregivers, which permitted nonpatient access to select MHAV functions. Laboratory and radiology results were accessible via MHAV. Results were classified into three groups based on sensitivity, which govern the length of delay before results appeared in MHAV. Discussion and Conclusion Patient portals offer significant opportunity to engage patients in their healthcare. However, there remains a need to understand how policies can promote uptake and use. We anticipate that other institutions can apply concepts from our policies to support meaningful patient portal engagement.

The My Diabetes Care Patient Portal Intervention: Usability and Pre-Post Assessment

“…2 As patient portal use grows, more research is needed to determine if patient portal interventions would work for adolescents including those with joint (child and guardian) access accounts. 51 Approximately 11% of individuals sent a recruitment letter responded. Whereas this response rate is similar to other studies, 52 it is relatively low and respondents-patients interested in participating in a study of a patient portal intervention for diabetes-may differ from the overall population in their attitudes, baseline levels of activation, and enthusiasm for technology-delivered interventions; therefore, our results may be subject to self-selection bias.…”

Rapid development of telehealth capabilities within pediatric patient portal infrastructure for COVID-19 care: barriers, solutions, results

“…MHAV serves patients of all ages and, prior to the pandemic, had robust policies and procedures in place to support in-person enrollment for children and adolescents. [18] In the existing MHAV policy framework, families with children (0-12 years) and adolescents (13-17 years) had to enroll in-person to verify identity and, in the case of adolescent patients, to ensure patient consent has been given for parental access to the patient's medical record. However, social distancing measures make in-person MHAV enrollment infeasible, and created a need for remote enrollment for MHAV to enable telehealth visits.…”

Evaluation of the My Diabetes Care Patient Portal Intervention: Protocol for a Pilot Randomized Controlled Trial

“…Finally, although patient portal interventions offer the advantages of direct integration into routine care, scalability, and sustainability, they are subject to inequities in patient portal adoption [ 43 ] and may appeal to more activated patients [ 44 ]. However, research shows that patient portal adoption is increasing [ 10 , 45 ], and if designed appropriately, patient portals could reduce health disparities [ 38 , 46 ]. Moreover, recent research finds that patient portal users have similar levels of patient activation as nonusers, although portal users are more likely to have internet access and a higher level of education [ 47 ].…”

“…MDC is embedded within an established patient portal, My Health at Vanderbilt (MHAV), at Vanderbilt University Medical Center (VUMC) [ 10 ]. MDC is a multi-faceted intervention designed to help patients better understand their diabetes health data and support self-management [ 9 ].…”

“…We recently applied a user-centered design sprint methodology and key strategies for patient engagement to develop a patient portal intervention called My Diabetes Care (MDC; formerly Diabetes Dashboard) [9]. MDC is embedded within an established patient portal, My Health at Vanderbilt (MHAV), at Vanderbilt University Medical Center (VUMC) [10]. MDC is a multi-faceted intervention designed to help patients better understand their diabetes health data and support self-management [9].…”