Improving Diabetes Care Through Effective Personalized Patient Portal Interactions

Diabetes Mellitus Clinical Trial

Official title:

Improving Diabetes Care Through Effective Personalized Patient Portal Interactions

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02953262
• Other study ID #: IIR 15-307
• Status: Completed
• Phase: N/A
• Start date: July 22, 2019
• Est. completion date: September 30, 2020

Study information

• Verified date: July 2023
• Source: VA Office of Research and Development
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Patient-facing eHealth technologies, such as online patient portals, connect patients with the healthcare system, help them access their health information, and support self-management of health conditions. This study tested an intervention to improve adoption and use of the My HealtheVet patient portal for diabetes management.

Description:

The goal of this small scale study is to test the feasibility of engaging Veterans in a supported adoption intervention to promote effective patient portal use in a sample of Veterans with uncontrolled Type II diabetes.

Participants were eligible for recruitment if they were Veterans age 18-85 who were actively receiving care at one of the study sites (as determined by having an upcoming scheduled appointment), had uncontrolled glucose (HbA1c >= 8.5%), and had either never used the VA patient portal or were inactive registrants who have not used the patient portal in the past 12 months. Participants who met these conditions and did not opt out of the study were randomized to one of four arms: 1) Encouragement I (brochure + mailed training guide), 2) Encouragement II (brochure + mailed training guide + invitation to group training), 3) Encouragement III (brochure + mailed training guide + invitation to group and one-on-one training), and 4) Comparison (standard patient portal enrollment brochure only). All arms received the standard My HealtheVet patient portal enrollment brochure along with an invitation to participate in the study. Those randomized to any of the Encouragement Arms received a mailed training guide. The My HealtheVet Training Guide for Veterans Living with Diabetes was designed in conjunction with Veteran co-investigators based on feedback from patients living with diabetes who were My HealtheVet users. It provided step by step guidance on how to use the features Veterans living with diabetes find most helpful with specific examples of use for diabetes self-management. Those in Encouragement Arm II were also invited to attend one of several group training sessions. Those in Encouragement III were invited to schedule a one-on one session to learn how to use the patient portal. Those in the comparison condition were asked during their interview if they would like a Training Guide mailed to them at the end of the trial, and those interested were mailed a Training Guide.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 275
• Est. completion date: September 30, 2020
• Est. primary completion date: July 5, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 85 Years

Eligibility

Inclusion Criteria:

• Veterans

• Hemoglobin A1c result >=8.5% at most recent lab test prior to recruitment

• Non use of the VA patient portal, defined by not being registered or registered with no activity in 12 months

• Currently being seen at one of the sites participating in the study (upcoming appointment scheduled)

Exclusion Criteria:

• Non-Veterans

• Controlled hemoglobin A1c levels (A1c<8.5%) at most recent lab test prior to recruitment

• Recent use of the patient portal

Related Conditions & MeSH terms

• Diabetes Mellitus

Intervention

Behavioral:
• My HealtheVet Brochure
Participants will receive a mailed brochure with basic My HealtheVet content.
• My HealtheVet Training Guide for Veterans Living with Diabetes
Participants will be mailed a bound My HealtheVet training guide with step by step instructions on how to register, upgrade to Premium account, refill prescriptions, use secure messaging, download their Blue Button reports, and other features
• My HealtheVet Group Training
Participants will be invited to participate in a scheduled group training to learn how to use My HealtheVet to help manage their diabetes
• My HealtheVet Individual Training
Participants will be invited to participate in a one-on-one training to learn how to use My HealtheVet to help manage their diabetes at a time of their convenience.

Locations

Country	Name	City	State
United States	VA Bedford HealthCare System, Bedford, MA	Bedford	Massachusetts
United States	VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA	Boston	Massachusetts

Sponsors (1)

Lead Sponsor	Collaborator
VA Office of Research and Development

Country where clinical trial is conducted

United States, 

References & Publications (4)

Robinson SA, Netherton D, Zocchi M, Purington C, Ash AS, Shimada SL. Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis. JMIR Diabetes. 2021 Nov 19;6(4):e32320. doi: 10.2196/323 — View Citation

Robinson SA, Zocchi MS, Netherton D, Ash A, Purington CM, Connolly SL, Vimalananda VG, Hogan TP, Shimada SL. Secure Messaging, Diabetes Self-management, and the Importance of Patient Autonomy: a Mixed Methods Study. J Gen Intern Med. 2020 Oct;35(10):2955- — View Citation

Stewart MT, Hogan TP, Nicklas J, Robinson SA, Purington CM, Miller CJ, Vimalananda VG, Connolly SL, Wolfe HL, Nazi KM, Netherton D, Shimada SL. The Promise of Patient Portals for Individuals Living With Chronic Illness: Qualitative Study Identifying Pathw — View Citation

Zocchi MS, Robinson SA, Ash AS, Vimalananda VG, Wolfe HL, Hogan TP, Connolly SL, Stewart MT, Am L, Netherton D, Shimada SL. Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration. J Am Med Inform Ass — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Any My HealtheVet Patient Portal Use	This measure captures any use of MHV within 180 days of the brochure mailing, including use of prescription refills, secure messaging, Blue Button, or any other portal features.	Portal use within 180 days of initial brochure mailing
Secondary	Patient Upgraded to a Premium My HealtheVet Portal Account	After registering for the portal, patients must confirm their identity and accept the terms and conditions of the portal in order to upgrade to Premium status which allows access to secure messaging, their VA appointments, and electronic health record extracts such as lab results, medical imaging and reports, clinical notes, and their VA health summary. Patients can access a limited subset of portal features, including online prescription refills, without upgrading to Premium. This measure captures whether a participant upgraded to a Premium account during the trial.	180 days from brochure mailing
Secondary	Use of Online Prescription Refills	This measure captures whether the participant used the portal's online prescription refill feature at least once within 180 days of mailing the brochure.	180 days from brochure mailing
Secondary	Use of Secure Messaging	Patient used the secure messaging feature during the trial	180 days from brochure mailing