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

• ClinicalTrials.gov Identifier: NCT02943109
• Recruitment Status: Completed
• First Posted: October 24, 2016
• Last Update Posted: May 15, 2020
• Sponsor: Ohio State University
• Information provided by (Responsible Party): Ann McAlearney, Ohio State University

Study Description

Brief Summary:

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.

Condition or disease	Intervention/treatment	Phase
Physician-Patient Relations; Inpatient Facility Diagnoses; Electronic Health Records; Outpatient	Other: High Touch; Other: Low Touch; Other: High Tech; Other: Low Tech	Not Applicable

Detailed Description:

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.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 3782 participants
• Allocation: Randomized
• Intervention Model: Factorial Assignment
• Masking: Single (Participant)
• Primary Purpose: Health Services Research
• Official Title: High Tech and High Touch (HT2): Transforming Patient Engagement Through Portal Technology at the Bedside
• Actual Study Start Date: December 2016
• Actual Primary Completion Date: February 2020
• Actual Study Completion Date: April 2020

Arms and Interventions

Arm	Intervention/treatment
Experimental: High tech, high touch; Patient receives the full version of MyChart Bedside. Patient receives training/intervention from technology navigator	Other: High Touch; Participants receives an in person visit from an "technology navigator" who helps to explain the technology to the patient.; Other: High Tech; Patient receives full-suite access to an inpatient patient portal with bi-directional communication enabled.
Experimental: Low tech, high touch; Patient receives the non-interactional version of MyChart Bedside. Patient receives training/intervention from technology navigator	Other: High Touch; Participants receives an in person visit from an "technology navigator" who helps to explain the technology to the patient.; Other: Low Tech; Patient receives a limited access version of the inpatient patient portal with bi-directional communication disabled.
Experimental: High tech, low touch; Patient receives the full version of MyChart Bedside. Patient receives online training, only	Other: Low Touch; Participants receives a visit from a "patient navigator" who helps to explain how to navigate the hospital system (active control).; Other: High Tech; Patient receives full-suite access to an inpatient patient portal with bi-directional communication enabled.
Experimental: Low tech, low touch; Patient receives the non-interactional version of MyChart Bedside. Patient receives online training, only	Other: Low Touch; Participants receives a visit from a "patient navigator" who helps to explain how to navigate the hospital system (active control).; Other: Low Tech; Patient receives a limited access version of the inpatient patient portal with bi-directional communication disabled.

Outcome Measures

Primary Outcome Measures :

1. MyChart Bedside Use [ Time Frame: through study completion, an average of 1 year ]
   Frequency of inpatient portal use (based on log file analysis)
2. Patient Satisfaction and Involvement with Care [ Time Frame: through study completion, an average of 1 year ]
   Survey responses on admission and post-discharge surveys; higher scores are better outcomes

Secondary Outcome Measures :

1. MyChart adoption and use [ Time Frame: Up to 3 months post-discharge ]
   Use of outpatient portal (based on log file analysis)
2. Self-Efficacy [ Time Frame: through study completion, an average of 1 year ]
   Survey responses on admission and post-discharge surveys; higher scores are better outcomes

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

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

Contacts and Locations

Locations

United States, Ohio

Ohio State University

Columbus, Ohio, United States, 43210

Sponsors and Collaborators

Ohio State University

Investigators

• Principal Investigator: Ann S McAlearney, ScD; Ohio State University

More Information

Publications:

McAlearney AS, Sieck CJ, Hefner JL, Aldrich AM, Walker DM, Rizer MK, Moffatt-Bruce SD, Huerta TR. High Touch and High Tech (HT2) Proposal: Transforming Patient Engagement Throughout the Continuum of Care by Engaging Patients with Portal Technology at the Bedside. JMIR Res Protoc. 2016 Nov 29;5(4):e221.

• Responsible Party: Ann McAlearney, Professor of Family Medicine and Executive Director, CATALYST, Ohio State University
• ClinicalTrials.gov Identifier: NCT02943109
• Other Study ID Numbers: R01HS024091 ( U.S. AHRQ Grant/Contract )
• First Posted: October 24, 2016
• Last Update Posted: May 15, 2020
• Last Verified: May 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Ann McAlearney, Ohio State University:

patient portal; Health Information Technology; Electronic Health Records; Inpatient Care; Outpatient Care; Patient Engagement