In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial

BackgroundElectronic patient portal (EPP) use is associated with lower no-show rates and increased patient satisfaction. However, there are disparities in enrollment into these communication platforms. ObjectiveWe hypothesized that guided inpatient enrollment into...

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Main Authors: Abhiram R Bhashyam, Mira Bansal, Madeline M McGovern, Quirine M J van der Vliet, Marilyn Heng
Format: Article
Language:English
Published: JMIR Publications 2022-08-01
Series:JMIR Perioperative Medicine
Online Access:https://periop.jmir.org/2022/1/e37148
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author Abhiram R Bhashyam
Mira Bansal
Madeline M McGovern
Quirine M J van der Vliet
Marilyn Heng
author_facet Abhiram R Bhashyam
Mira Bansal
Madeline M McGovern
Quirine M J van der Vliet
Marilyn Heng
author_sort Abhiram R Bhashyam
collection DOAJ
description BackgroundElectronic patient portal (EPP) use is associated with lower no-show rates and increased patient satisfaction. However, there are disparities in enrollment into these communication platforms. ObjectiveWe hypothesized that guided inpatient enrollment into an EPP would improve clinical follow-up and EPP use rates for patients who underwent orthopedic surgery compared to the usual practice of providing information in the discharge summary. MethodsWe performed a randomized controlled trial of 229 adult patients who were admitted to the hospital for an orthopedic condition that required a 3-month follow-up visit. Patients were cluster-randomized by week to either the control or intervention group. The control group received information on how to enroll into and use the EPP in their discharge paperwork, whereas the intervention group was actively enrolled and taught how to use the EPP. At 3 months postdischarge, the patients were followed to see if they attended their follow-up appointment or used the EPP. ResultsOf the 229 patients, 83% (n=190) presented for follow-up at 3 months (control: 93/116, 80.2%; intervention: 97/113, 85.8%; P=.25). The likelihood of EPP use was significantly higher in the intervention group (control: 19/116, 16.4%; intervention: 70/113, 62%; odds ratio [OR] 8.3, 95% CI 4.5-15.5; P<.001). Patients in the intervention group who used the EPP were more likely to present for postsurgical follow-up (OR 3.59, 95% CI 1.28-10.06; P=.02). ConclusionsThe inpatient enrollment of patients who underwent orthopedic surgery into an EPP increased EPP use but did not independently result in enhanced follow-up. Patients who were enrolled as inpatients and subsequently used the portal had the highest likelihood of 3-month follow-up. Trial RegistrationClinicalTrials.gov NCT03431259; https://clinicaltrials.gov/ct2/show/NCT03431259
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spelling doaj.art-7b650d04697040ffbeb57741a3f66b972024-02-03T09:07:28ZengJMIR PublicationsJMIR Perioperative Medicine2561-91282022-08-0151e3714810.2196/37148In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled TrialAbhiram R Bhashyamhttps://orcid.org/0000-0002-9170-4745Mira Bansalhttps://orcid.org/0000-0002-7987-3976Madeline M McGovernhttps://orcid.org/0000-0001-7618-6073Quirine M J van der Vliethttps://orcid.org/0000-0001-5515-0952Marilyn Henghttps://orcid.org/0000-0002-4047-6818 BackgroundElectronic patient portal (EPP) use is associated with lower no-show rates and increased patient satisfaction. However, there are disparities in enrollment into these communication platforms. ObjectiveWe hypothesized that guided inpatient enrollment into an EPP would improve clinical follow-up and EPP use rates for patients who underwent orthopedic surgery compared to the usual practice of providing information in the discharge summary. MethodsWe performed a randomized controlled trial of 229 adult patients who were admitted to the hospital for an orthopedic condition that required a 3-month follow-up visit. Patients were cluster-randomized by week to either the control or intervention group. The control group received information on how to enroll into and use the EPP in their discharge paperwork, whereas the intervention group was actively enrolled and taught how to use the EPP. At 3 months postdischarge, the patients were followed to see if they attended their follow-up appointment or used the EPP. ResultsOf the 229 patients, 83% (n=190) presented for follow-up at 3 months (control: 93/116, 80.2%; intervention: 97/113, 85.8%; P=.25). The likelihood of EPP use was significantly higher in the intervention group (control: 19/116, 16.4%; intervention: 70/113, 62%; odds ratio [OR] 8.3, 95% CI 4.5-15.5; P<.001). Patients in the intervention group who used the EPP were more likely to present for postsurgical follow-up (OR 3.59, 95% CI 1.28-10.06; P=.02). ConclusionsThe inpatient enrollment of patients who underwent orthopedic surgery into an EPP increased EPP use but did not independently result in enhanced follow-up. Patients who were enrolled as inpatients and subsequently used the portal had the highest likelihood of 3-month follow-up. Trial RegistrationClinicalTrials.gov NCT03431259; https://clinicaltrials.gov/ct2/show/NCT03431259https://periop.jmir.org/2022/1/e37148
spellingShingle Abhiram R Bhashyam
Mira Bansal
Madeline M McGovern
Quirine M J van der Vliet
Marilyn Heng
In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial
JMIR Perioperative Medicine
title In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial
title_full In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial
title_fullStr In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial
title_full_unstemmed In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial
title_short In-hospital Enrollment Into an Electronic Patient Portal Results in Improved Follow-up After Orthopedic Surgery: Cluster Randomized Controlled Trial
title_sort in hospital enrollment into an electronic patient portal results in improved follow up after orthopedic surgery cluster randomized controlled trial
url https://periop.jmir.org/2022/1/e37148
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