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CC BY-NC-ND 4.0 · Appl Clin Inform 2018; 09(04): 875-883
DOI: 10.1055/s-0038-1676333
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Communicating with Vulnerable Patient Populations: A Randomized Intervention to Teach Inpatients to Use the Electronic Patient Portal

Jacob N. Stein
1   Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
,
Jared W. Klein
1   Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
,
Thomas H. Payne
1   Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
2   Information Technology Services, University of Washington School of Medicine, Seattle, Washington, United States
,
Sara L. Jackson
1   Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
,
Sue Peacock
1   Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
,
Natalia V. Oster
1   Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
,
Trinell P. Carpenter
1   Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States
,
Joann G. Elmore
3   University of California, Los Angeles, California, United States
› Author Affiliations Funding This study was generously funded by the Robert Wood Johnson Foundation, the Gordon & Betty Moore Foundation, the Peterson Center on Healthcare, and the Cambia Health Foundation.
Further Information

Publication History

28 June 2018

14 October 2018

Publication Date:
12 December 2018 (online)

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Abstract

Background Patient portals are expanding as a means to engage patients and have evidence for benefit in the outpatient setting. However, few studies have evaluated their use in the inpatient setting, or with vulnerable patient populations.

Objective This article assesses an intervention to teach hospitalized vulnerable patients to access their discharge summaries using electronic patient portals.

Methods Patients at a safety net hospital were randomly assigned to portal use education or usual care. Surveys assessed perceptions of discharge paperwork and the electronic portal.

Results Of the 202 prescreened eligible patients (e.g., deemed mentally competent, spoke English, and had a telephone), only 43% had working emails. Forty-four percent of participants did not remember receiving or reading discharge paperwork. Patients trained in portal use (n = 47) or receiving usual care (n = 23) preferred hospitals with online record access (85 and 83%, respectively), and felt that online access would increase their trust in doctors (85 and 87%) and satisfaction with care (91% each). Those who received training in portal use were more likely to register for the portal (48% vs. 11%; p < 0.01).

Conclusion Patients had positive perceptions of portals, and education increased portal use. Lack of email access is a notable barrier to electronic communication with vulnerable patients.

Keywords

patient portal - discharge summary - communication barriers - inpatient care - discharge planning

Protection of Human and Animal Subjects

This study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research involving Human Subjects and was reviewed by the University of Washington Institutional Review Board.


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