High Tech and High Touch (HT2): Transforming Patient Engagement Through Portal Technology at the Bedside

Study Overview
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Brief Summary
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A large-scale randomized control trial (RCT) of the impact and use of an inpatient tablet-based patient portal embedded in a larger mixed methods study to examine changes in patient experiences and outcomes, and subsequent ambulatory patient portal usage.

Detailed Description
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The appropriate use of technology to actively engage with patients who suffer from multiple chronic conditions, called multimorbidity, is one of the frontiers of both research and practice. For multimorbid patients, engagement in disease management activities is particularly critical, and evidence shows that enhanced patient self-management can lead to better control of chronic illness. One tool finding increasing use is the patient portal, and its pervasiveness is supported by virtue of its role as a component of the Meaningful Use criteria. A patient portal is a tethered personal health record (tPHR) that links to the patient's electronic health record, facilitating communication and engagement activities with healthcare providers. While most tPHRs have been focused on outpatient activities, a new class of tools focused on the inpatient experience has begun deployment in 2014. In response, this study supports the conduct of the first, large-scale randomized control trial (RCT) of the impact and use of an inpatient tablet-based patient portal embedded in a larger mixed methods study to examine changes in patient experiences and outcomes, and subsequent ambulatory patient portal usage. The investigators aim to study how access to a patient portal tailored to the inpatient stay can improve patient experience and increase patient engagement by improving patients' perception of the process of care while in the hospital (patient experience), increasing patients' self-efficacy for managing their chronic conditions (patient engagement), and facilitating use of a patient portal for care management activities after discharge (patient engagement). The study site is a world-class healthcare facility with the ability to provide access to a patient portal designed specifically for the inpatient experience, bridging to outside the hospital after discharge. Currently, this inpatient technology exists in only one other hospital in the US, but the investigators expect that as inpatient PHRs become more readily available, the need for clarity on this issue will only increase. The investigator's evaluation is a mixed-methods design consisting of primary data collection through surveys and interviews throughout the study period, and secondary data collection from the electronic health record and health system metadata. This study will offer insight into a potentially important mechanism to facilitate patient self-management.

Official Title
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High Tech and High Touch (HT2): Transforming Patient Engagement Through Portal Technology at the Bedside

Conditions
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Physician-Patient Relations, Inpatient Facility Diagnoses, Electronic Health Records, Outpatient

Intervention / Treatment
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* Other: High Touch
* Other: Low Touch
* Other: High Tech
* Other: Low Tech


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: patient accepted MyChart Bedside tablet patient available in their room capable of providing informed consent Exclusion criteria: Patient in a pilot unit where Full Tech was available prior to study start Patient was less than 18 years of age

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: High tech, high touch<br>Patient receives the full version of MyChart Bedside. Patient receives training/intervention from technology navigator | Other: High Touch<br>* Participants receives an in person visit from an technology navigator who helps to explain the technology to the patient.<br>Other: High Tech<br>* Patient receives full-suite access to an inpatient patient portal with bi-directional communication enabled.<br>|
| Experimental: Low tech, high touch<br>Patient receives the non-interactional version of MyChart Bedside. Patient receives training/intervention from technology navigator | Other: High Touch<br>* Participants receives an in person visit from an technology navigator who helps to explain the technology to the patient.<br>Other: Low Tech<br>* Patient receives a limited access version of the inpatient patient portal with bi-directional communication disabled.<br>|
| Experimental: High tech, low touch<br>Patient receives the full version of MyChart Bedside. Patient receives online training, only | Other: Low Touch<br>* Participants receives a visit from a patient navigator who helps to explain how to navigate the hospital system (active control).<br>Other: High Tech<br>* Patient receives full-suite access to an inpatient patient portal with bi-directional communication enabled.<br>|
| Experimental: Low tech, low touch<br>Patient receives the non-interactional version of MyChart Bedside. Patient receives online training, only | Other: Low Touch<br>* Participants receives a visit from a patient navigator who helps to explain how to navigate the hospital system (active control).<br>Other: Low Tech<br>* Patient receives a limited access version of the inpatient patient portal with bi-directional communication disabled.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MyChart Bedside Use | Frequency of inpatient portal use (based on log file analysis) | through study completion, an average of 1 year | 
| Patient Satisfaction and Involvement with Care | Survey responses on admission and post-discharge surveys; higher scores are better outcomes | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MyChart adoption and use | Use of outpatient portal (based on log file analysis) | Up to 3 months post-discharge | 
| Self-Efficacy | Survey responses on admission and post-discharge surveys; higher scores are better outcomes | through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patient portal, Health Information Technology, Electronic Health Records, Inpatient Care, Outpatient Care, Patient Engagement