NorthPoint Domain

e-Health Portals Help Patients Participate in Care

No-show rates decreased significantly in portal enrollees

Internet portal technologies may help patients become more involved in their care and reduce no-show rates, according to a study published recently in the Journal of Medical Internet Research.

Use of the internet for healthcare-related purposes has exploded in recent years. One of the newer tools is the health portal, a web-based application that allows patients to securely and privately review their electronic health record, schedule appointments, review medications, send messages to providers, and locate educational information. Limited data existed on its use and impact, however. The authors of the current study thus sought to test effects in a group of patients who were either enrolled or not enrolled (nonusers) in the Duke Medicine HealthView portal (HVP). They specifically wanted to see if portal enrollment with an email appointment reminder function would decrease appointment no-shows, which are a known barrier to clinical efficiency.

Participants (58,942) attended one of seven Duke University clinics between January 1, 2008 and December 31, 2008. The authors assessed the demographic profiles of HVP enrollees and nonusers as well as the relationship between enrollment and appointment no-show rates (the percentage of all arrived and no-show appointments in total that were no-show appointments). Monthly no-show rates were also calculated to demonstrate the effect of HVP use over time.

Overall, nonusers of HVP were 2.26 times as likely to miss a scheduled appointment as enrollees who received email reminders. The authors noted that although male nonusers had higher no-show rates than female nonusers, male enrollees showed up more than female enrollees, making them a potential subgroup to target. Patient enrollees between 18 and 29 years had the greatest reduction in no-show rates while those 65 years and older showed the least reduction. This finding may be due to older people being more independently active in managing their own care as well as not as internet-savvy, the authors write. In addition, historically disadvantaged groups (the uninsured, those on Medicaid, and African Americans) appeared to show up the most because of HVP participation. The authors conclude that “this technology may have important beneficial effects on clinic operations, as nonusers would have only received mail and telephone reminders.”

Source: Horvath M, Levy J, L'Engle P, et al. 2011. Impact of health portal enrollment with email reminders on adherence to clinic appointments: a pilot study. Journal of Medical Internet Research 13(2):e41.