Email Campaign to Increase Uptake of myGeisinger

Study Overview
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Brief Summary
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The purpose of the current study is to test different email messages to determine the most effect way of promoting enrollment in Geisinger's patient portal, called myGeisinger.

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, fewer than half of patients have enrolled in Geisinger's patient portal, myGeisinger. The purpose of the current study is to assess what kind of messaging improves the effectiveness of an email campaign targeted at enrolling patients into Geisinger's online patient portal, called myGeisinger. Currently, Geisinger sends an email every month to patients who have started but not completed the enrollment process (they have had an activation code generated but have not yet used that code to enroll). This study will A/B test 5 email messages to assess if they perform better than the current standard email message. Performance will be assessed based on whether patients open the email, click on the myGeisinger enrollment link, and enroll in myGeisinger. Statistical analyses will employ generalized linear models with a binary distribution and log-link function.

Official Title
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Email Campaign to Encourage Patients to Complete Sign-up Process for Geisinger's Patient Portal

Conditions
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Telehealth, Health Behavior

Intervention / Treatment
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* Behavioral: Less-is-better
* Behavioral: Social proof
* Behavioral: Endowment / decision staging
* Behavioral: Standard email


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Geisinger patients whose myGeisinger status is Pending, meaning an activation code has been generated for them, but they have not completed activation Exclusion Criteria: Patients without email addresses on file Patients who received emails from this monthly myGeisinger marketing campaign within the last 2 months

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 88 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Control<br>A standard marketing message encouraging activation and describing the benefits of myGeisinger | Behavioral: Standard email<br>* Email<br>|
| Focused on provider communication<br>A simple message focused on one benefit of myGeisinger: communicating easily with providers | Behavioral: Less-is-better<br>* Email<br>|
| Focused on scheduling<br>A simple message focused on one benefit of myGeisinger: scheduling and managing appointments online | Behavioral: Less-is-better<br>* Email<br>|
| Focused on medical information access<br>A simple message focused on one benefit of myGeisinger: accessing medical information, like test results | Behavioral: Less-is-better<br>* Email<br>|
| Social proof<br>A message similar to control, but including information about how many other patients are using myGeisinger | Behavioral: Social proof<br>* Email<br>|
| Endowment / decision staging<br>A message similar to control, but framing myGeisinger as something that patients already have, and just need to take one more step to activate. Endowment: Give patients the impression they already have the account, so they value it more. Decision staging: Break down the process into multiple stages - having an account and activating that account- and giving the impression that they are almost there because the first stage is complete | Behavioral: Endowment / decision staging<br>* Email<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Email Opened: Control vs. Less-is-better vs. Social Proof vs. Endowment | Whether email was opened (yes / no) | 8-10 days post-intervention | 
| Link Clicked: Control vs. Less-is-better vs. Social Proof vs. Endowment | Whether the link / button to start the activation process was clicked (yes / no) | 8-10 days post-intervention | 
| Enrollment: Control vs. Less-is-better vs. Social Proof vs. Endowment | Whether the patient enrolled in myGeisinger (yes / no) | 8-10 days post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Email Opened: Control vs. Less-is-better vs. Social Proof vs. Endowment | Whether email was opened (yes / no) | 32-35 days post-intervention | 
| Link Clicked: Control vs. Less-is-better vs. Social Proof vs. Endowment | Whether the link / button to start the activation process was clicked (yes / no) | 32-35 days post-intervention | 
| Enrollment: Control vs. Less-is-better vs. Social Proof vs. Endowment | Whether the patient enrolled in myGeisinger (yes / no) | 32-35 days post-intervention | 
| Email Opened: Within Less-is-better (Provider Communication vs. Managing Appointments vs. Medical Information Access) | Whether email was opened (yes / no) | 8-10 days post-intervention | 
| Link Clicked: Within Less-is-better (Provider Communication vs. Managing Appointments vs. Medical Information Access) | Whether the link / button to start the activation process was clicked (yes / no) | 8-10 days post-intervention | 
| Enrollment: Within Less-is-better (Provider Communication vs. Managing Appointments vs. Medical Information Access) | Whether the patient enrolled in myGeisinger (yes / no) | 8-10 days post-intervention | 
| Email Opened: Within Less-is-better (Provider Communication vs. Managing Appointments vs. Medical Information Access) | Whether email was opened (yes / no) | 32-35 days post-intervention | 
| Link Clicked: Within Less-is-better (Provider Communication vs. Managing Appointments vs. Medical Information Access) | Whether the link / button to start the activation process was clicked (yes / no) | 32-35 days post-intervention | 
| Enrollment: Within Less-is-better (Provider Communication vs. Managing Appointments vs. Medical Information Access) | Whether the patient enrolled in myGeisinger (yes / no) | 32-35 days 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, Social Proof, Endowment Effect, Less-is-better