The Use of Navigators to Increase Patient Portal Enrollment among Patients in a Federally Qualified Health Care System
Alicia K. Matthews, Alana D. Steffen, Larisa A. Burke, Geri Donenberg, Cherdsak Duangchan, Jennifer Akufo, Hope Opuada, Damilola Oyaluade, Brittany Harris Vilona, Hilda Diaz, Darcy DoddPurpose
To describe the training, preliminary results, and lessons learned from using patient navigators to increase the enrollment of low-income patients in a health system–supported and electronic health record–linked patient portal.
Methods
Patient navigators (n=4) were trained to assist patients in a federally qualified health center to enroll in and use patient portals. Patient navigators were stationed at 3 clinic locations. Data from the electronic health record system (Epic) were used to compare MyChart patient portal activation rates and use among patients for the 8 months before and after patient navigation services were offered.
Results
Navigators offered 83% of eligible patients with activation assistance. Sixty-four percent of the patients (n=1062) offered MyChart enrollment assistance accepted help. Seventy-four percent of assisted patients with no prior MyChart enrollment activated their accounts during that clinic visit. The primary reason for declining MyChart assistance was a lack of access to or comfort with technology. Patient portal activation increased during the 8 months when navigators were at the clinics (51%) compared to the previous 8 months (44%). Most new users viewed lab results and read a message [χ2(1)=49.3, p<.001], with significant increases evident for African Americans [44% before, 49% during; χ2(1)=40.4, p<.001] and Latinx patients [52% before, 60% during; χ2(1)=6.15, p=.013].
Conclusion
Study results suggest that using patient navigators is feasible and beneficial for increasing patient enrollment in the Federally Qualified Health Centers context. However, patient-, clinic-, and system-level factors were identified as barriers and should be addressed in future research studies.