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Completed

NCT Number: NCT02943109

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

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.

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Key information

Conditions

Physician-Patient Relations Behavior Electronic Health Records Health Behavior Inpatient Facility Diagnoses Outpatient Patient Acceptance of Health Care Patient Participation Treatment Adherence and Compliance

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ohio State University

Columbus, Ohio, 43210, United States

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

High Touch

Other

Participants receives an in person visit from an "technology navigator" who helps to explain the technology to the patient.

Low Touch

Other

Participants receives a visit from a "patient navigator" who helps to explain how to navigate the hospital system (active control).

High Tech

Other

Patient receives full-suite access to an inpatient patient portal with bi-directional communication enabled.

Low Tech

Other

Patient receives a limited access version of the inpatient patient portal with bi-directional communication disabled.

Primary outcomes

  1. Inpatient Portal Use Frequency

    Time frame: At hospital discharge.

    The count of MyChart Bedside (inpatient portal) sessions for the admission associated with study enrollment.

  2. Inpatient Portal Comprehensiveness of Use

    Time frame: At hospital discharge.

    Based on the use of all available MyChart Bedside (inpatient portal) functions, a comprehensive inpatient portal user was one who used all three functions - for patients in the low tech assignment - or used eight or more functions - for patients in the high tech assignment.

  3. Inpatient Portal Functions Proportion of Use

    Time frame: At hospital discharge.

    For each MyChart Bedside (inpatient portal) function available to patients assigned to high tech, a proportion of total use is calculated for each patient as the sum of actions in a given function divided for the total sum of user actions during the hospital admission associated with study enrollment.

  4. Patient Satisfaction With Care - Responses From Healthcare Professionals

    Time frame: 15 days after discharge

    Questions from the satisfaction and experience domains of the 15-day Post-discharge surveys were used to assess patient satisfaction with their care. Answers to the following 5-point Likert scale survey item were explored: "In your most recent hospital experience, how satisfied were you with how well your healthcare professionals responded to your concerns? ". Responses were dichotomized to one "most positive" response versus all other responses.

  5. Patient Satisfaction With Care - Interactions With Healthcare Professionals

    Time frame: 15 days after discharge

    Questions from the satisfaction and experience domains of the 15-day Post-discharge surveys were used to assess patient satisfaction with their care. Answers to the following 5-point Likert scale survey item were explored: "In your most recent hospital experience, how satisfied were you with the interactions you had with your healthcare professionals? ". Responses were dichotomized to one "most positive" response versus all other responses.

  6. Patient Satisfaction With Care - Responses From Healthcare Professionals

    Time frame: 6 months after discharge

    Questions from the satisfaction and experience domains of the 6-month Post-discharge surveys were used to assess patient satisfaction with their care. Answers to the following 5-point Likert scale survey item were explored: "In the past 6 months, how satisfied were you with how well your healthcare professionals responded to your concerns? ". Responses were dichotomized to one "most positive" response versus all other responses.

  7. Patient Satisfaction With Care - Interactions With Healthcare Professionals

    Time frame: 6 months after discharge

    Questions from the satisfaction and experience domains of the 6-month Post-discharge surveys were used to assess patient satisfaction with their care. Answers to the following 5-point Likert scale survey item were explored: "In your most recent hospital experience, how satisfied were you with the interactions you had with your healthcare professionals? ". Responses were dichotomized to one "most positive" response versus all other responses.

  8. Patient Involvement With Care - Questions About Health Management

    Time frame: 15 days after discharge.

    Questions from the involvement with care domain of the 15-day Post-discharge surveys were used to assess patient involvement with their care. Answers to the following 5-point Likert scale survey item were explored: "All of my questions about managing my health, including my medications, were addressed before I left the hospital.". Responses were dichotomized to one "most positive" response versus all other responses.

  9. Patient Involvement With Care - Finding Answers to Health Management Questions

    Time frame: 15 days after discharge.

    Questions from the involvement with care domain of the 15-day Post-discharge surveys were used to assess patient involvement with their care. Answers to the following multiple-choice survey item were explored: "If you had a question about your care while you were in the hospital, what steps did you take to find an answer? (mark all that apply)".

  10. Patient Involvement With Care - Tablet's Activities

    Time frame: 15 days after discharge.

    Questions from the involvement with care domain of the 15-day Post-discharge surveys were used to assess patient involvement with their care. Answers to the following multiple-choice survey item were explored: "What kind of activities did you use the table for? (mark all that apply)".

Secondary outcomes

  1. Outpatient Portal Adoption

    Time frame: 3 months post-discharge

    MyChart (outpatient portal) accounts activated by participants after their enrollment in the study (based on log file analysis).

  2. Outpatient Portal Frequency of Use

    Time frame: 3 months post-discharge

    Count of MyChart (outpatient portal) sessions (based on log file analysis).

  3. Self-Efficacy

    Time frame: Baseline

    5-point Likert scale built on the participant responses to 6 self-efficacy-related items from the admission survey. Self-efficacy measures the belief in one's capacity to complete a task, rather than the relevant skills possessed. Scale developed on the basis of Bandura, A. (2006). Guide for constructing self-efficacy scales. In F. Pajares & T. Urdan (Eds.). Self-Efficacy Beliefs of Adolescent. Greenwich, CT: Information Age Publishing, pp. 307-337.

    Self-Efficacy scale:

    • min value: 1;
    • max value: 5;
    • higher scores are better outcomes.

  4. Self-Efficacy

    Time frame: 15 days post-discharge

    5-point Likert scale built on the participant responses to 6 self-efficacy-related items from the admission survey. Self-efficacy measures the belief in one's capacity to complete a task, rather than the relevant skills possessed. Scale developed on the basis of Bandura, A. (2006). Guide for constructing self-efficacy scales. In F. Pajares & T. Urdan (Eds.). Self-Efficacy Beliefs of Adolescent. Greenwich, CT: Information Age Publishing, pp. 307-337.

    Self-Efficacy scale:

    • min value: 1;
    • max value: 5;
    • higher scores are better outcomes.

  5. Self-Efficacy

    Time frame: 6 months post-discharge

    5-point Likert scale built on the participant responses to 6 self-efficacy-related items from the admission survey. Self-efficacy measures the belief in one's capacity to complete a task, rather than the relevant skills possessed. Scale developed on the basis of Bandura, A. (2006). Guide for constructing self-efficacy scales. In F. Pajares & T. Urdan (Eds.). Self-Efficacy Beliefs of Adolescent. Greenwich, CT: Information Age Publishing, pp. 307-337.

    Self-Efficacy scale:

    • min value: 1;
    • max value: 5;
    • higher scores are better outcomes.

Sponsors and collaborators

Lead sponsor

Ohio State University

Other

Registry information

Important dates

Study start
2016
Primary completion
2020
Study completion
2020
First posted
Oct 24, 2016
Registry last updated
Jul 22, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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