一项紧急护理-社区合作项目以减少患者门户使用差异的可行性与有效性：质量改进项目

Feasibility and Effectiveness of an Urgent Care-Community Partnership to Reduce Disparities in Patient Portal Uptake: Quality Improvement Project.

作者信息

Sanders Mechelle, Sanders Amaya, Herbert Erik, Booker Naomi Rosie, Wang Sandy, Fiscella Kevin

机构信息

Department of Family Medicine, University of Rochester, 1381 South Ave, Rochester, NY, 14620, United States, 1 5853244566, 1 5854732245.

College of Arts and Sciences, Howard University, Washington, DC, United States.

出版信息

J Particip Med. 2025 Jun 5;17:e69253. doi: 10.2196/69253.

DOI:10.2196/69253

PMID:40472267

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12161615/

Abstract

BACKGROUND

Patient portals demonstrate significant potential for improving health care engagement but face critical adoption challenges. Disparities persist across different demographic groups, creating a digital divide in health care access. Targeted training strategies, particularly personalized and one-on-one approaches, show promise in increasing portal utilization. Innovative solutions, like community health workers specializing in digital navigation, offer a potential pathway to reduce enrollment barriers. The key challenge remains developing a scalable, cost-effective training model.

OBJECTIVE

Our quality improvement (QI) project aimed to assess the feasibility and effectiveness of a collaborative effort between a free community-based digital navigation program and an urgent care clinic in facilitating patient access to their portal.

METHODS

We created the Digital Health Equity Navigation Training (DHENT) program to improve patient portal access and usage. The program used a train-the-trainer model to scale up patient portal training across the community. DHENT trainers partnered with urgent care physicians to enroll patients in the portal. Physicians briefly explained portal benefits and referred interested patients for DHENT assistance. Trainers then contacted patients by phone to help with enrollment and navigation. We employed 3 Plan-Do-Study-Act cycles to understand the feasibility of the collaboration. We used descriptive statistics to describe participant characteristics and referral processes.

RESULTS

The collaboration was marginally successful, exceeding referral targets by 27.7% (115/90). Most patients were under 60 years old (94/115, 81.7%) and White (78/115, 67.8%). There was a significant delay in contact, averaging 37 days. While 4.8% (5/104) of patients accessed the portal with DHENT trainer assistance, 9.6% (10/104) had already signed up independently after their urgent care visit.

CONCLUSIONS

Overall, we found our partnership had a moderate impact, and only a low dose of intervention and resources were needed.

摘要

背景

患者门户网站在改善医疗保健参与度方面显示出巨大潜力，但面临着关键的采用挑战。不同人口群体之间的差距依然存在，在医疗保健获取方面造成了数字鸿沟。有针对性的培训策略，特别是个性化和一对一的方法，在提高门户网站利用率方面显示出前景。创新解决方案，如专门从事数字导航的社区卫生工作者，提供了一条减少注册障碍的潜在途径。关键挑战仍然是开发一种可扩展、具有成本效益的培训模式。

目的

我们的质量改进（QI）项目旨在评估一个基于社区的免费数字导航项目与一家紧急护理诊所之间的合作在促进患者访问其门户网站方面的可行性和有效性。

方法

我们创建了数字健康公平导航培训（DHENT）项目，以改善患者对门户网站的访问和使用。该项目采用培训培训师模式，在社区范围内扩大患者门户网站培训。DHENT培训师与紧急护理医生合作，让患者注册门户网站。医生简要解释了门户网站的好处，并将感兴趣的患者转介给DHENT寻求帮助。然后培训师通过电话联系患者，帮助他们注册和导航。我们采用了3个计划-执行-研究-行动周期来了解合作的可行性。我们使用描述性统计来描述参与者特征和转介过程。

结果

合作取得了一定成功，超出转介目标27.7%（115/90）。大多数患者年龄在60岁以下（94/115，81.7%），且为白人（78/115，67.8%）。联系存在显著延迟，平均为37天。虽然4.8%（5/104）的患者在DHENT培训师的帮助下访问了门户网站，但9.6%（10/104）的患者在紧急护理就诊后已经自行注册。