Timely Nudge About Lab Results to Increase myGeisinger Uptake

Study Overview
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Brief Summary
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The purpose of the current study is to test whether sending email communications in a timely manner - when patients have laboratory results available to view on the myGeisinger patient portal - increases enrollment in the portal.

Detailed Description
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Online patient portals are convenient tools that improve patient access to healthcare services while often reducing burden to both patients and providers. However, many patients have not enrolled in such portals, including Geisinger's patient portal, known as myGeisinger. The purpose of the current study is to test whether sending myGeisinger enrollment information in a timely manner - when the benefits of enrolling are most readily available - increases enrollment. Specifically, messages will be timely in terms of lab test results having just been made available online, with the added benefit that patients can view their results prior to receiving them via mail. Unenrolled patients who recently had a laboratory procedure ordered and whose results are now ready for sharing will be informed via email that their lab results are available. At the same time, these patients will be reminded that these results can be viewed online through myGeisinger. The primary outcome measure of interest, myGeisinger enrollment rates, will be compared between the emailed population and a control group that similarly has lab results available but will not be contacted. In addition, two different versions of the email communication will be tested. One will highlight that the patient will have to go through a sign-up process before viewing test results (in the service of transparency). The other will provide a presumed direct link to view those results, via a button that potentially serves as a pre-commitment step to undergo the registration process (foot in the door effect). Secondary analyses will assess differences in enrollment rates as well as unsubscribe rates between the email versions. Exploratory analyses will further examine differences in the rates at which patients opened and clicked on enrollment links within the two emails. Statistical analyses will employ generalized linear models with a binary distribution and log-link function.

Official Title
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Nudging myGeisinger Enrollment Using Timely Email Messaging Reminding Patients of Lab Results Available

Conditions
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Telehealth, Health Behavior

Intervention / Treatment
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* Behavioral: Timely
* Behavioral: Transparency
* Behavioral: Foot-in-the-door


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Geisinger patient for whom a lab was ordered within 30 days prior to email date Patient's lab test result released day before email date Exclusion Criteria: Patient already enrolled in myGeisinger Patient has already declined myGeisinger

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: Parallel Assignment
Interventional Model Description: Every day within the designated study period, an email will be sent to patients who 1) fulfill inclusion criteria, 2) have been randomized to one of the email conditions (rather than the control group), and 3) have not already been randomized to a study condition on a previous day (i.e. no patient will be emailed for this study twice).
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>Patients do not receive an email | |
| Experimental: Timely nudge - view results<br>Patients are emailed about myGeisinger when they have a lab result ready to view. The email includes a View My Lab Results button, which encourages them to click as a pre-commitment step that then brings them to the myGeisinger sign-up page. | Behavioral: Timely<br>* Email<br>Behavioral: Foot-in-the-door<br>* Email<br>|
| Experimental: Timely nudge - get started<br>Patients are emailed about myGeisinger when they have a lab result ready to view. The email includes a Get Started With myGeisinger button that is transparent about the next step in the process, before the patient can view test results. | Behavioral: Timely<br>* Email<br>Behavioral: Transparency<br>* Email<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enrollment - Timely Email (Combined Email Arms) vs. no Intervention | Patient enrolled in myGeisinger (yes / no) | 1 week post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enrollment - Email Including a Get Started Button vs. a View Results Button | Patient enrolled in myGeisinger (yes / no) | 1 week post-intervention | 
| Email Opened - Email Including a Get Started Button vs. a View Results Button | Email was opened (yes / no) | 1 week post-intervention | 
| Link Clicked - Email Including a Get Started Button vs. a View Results Button | Link / button to start the enrollment process was clicked (yes / no) | 1 week post-intervention | 
| Unsubscribed - Email Including a Get Started Button vs. a View Results Button | Patient unsubscribed from these email communications (yes / no) | 1 month post-intervention | 
| Enrollment - Timely Email (Combined Email Arms) vs. no Intervention | Patient enrolled in myGeisinger (yes / no) | 1 month post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Behavioral Economics, Patient Portal