Download PDF
CC BY 4.0 · ACI open 2021; 05(01): e17-e26
DOI: 10.1055/s-0041-1729983
Original Article

Rapid Implementation of Remote Online Patient Portal Activation in a Children's Hospital during the COVID-19 Pandemic

Kim T. Vuong
1   Department of Pediatrics, Rady Children's Hospital, San Diego, California, United States
2   Department of Pediatrics, University of California, San Diego, San Diego, California, United States
,
Tiranun Rungvivatjarus
1   Department of Pediatrics, Rady Children's Hospital, San Diego, California, United States
2   Department of Pediatrics, University of California, San Diego, San Diego, California, United States
,
Isabel P. Garcia
1   Department of Pediatrics, Rady Children's Hospital, San Diego, California, United States
,
Cindy Lewis
1   Department of Pediatrics, Rady Children's Hospital, San Diego, California, United States
,
Lisa Miller
1   Department of Pediatrics, Rady Children's Hospital, San Diego, California, United States
,
Cynthia L. Kuelbs
1   Department of Pediatrics, Rady Children's Hospital, San Diego, California, United States
2   Department of Pediatrics, University of California, San Diego, San Diego, California, United States
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background Patient portal access allows more patient engagement, yet portal usage is not universal. Telemedicine visits became critical when the coronavirus disease 2019 (COVID-19) pandemic limited in-office visits. Given physical distancing requirements and telemedicine platform integrated into the patient portal, our institution needed to rapidly enroll patients and their proxies remotely, including hospitalized patients, to minimize care disruptions.

Objectives The study aimed to describe the rapid implementation of remote patient portal activation in a pediatric integrated delivery network during the COVID-19 pandemic. Additionally, to increase the percentage of patients with active portal status upon discharge by 15% (absolute change) across inpatient units within 3 months.

Methods A multidisciplinary taskforce utilized quality improvement tools to identify barriers to successful inpatient patient portal activation followed by rapid intervention cycles to effect change. Weekly progress was monitored on a portal activation dashboard.

Results We created clinical decision support tools and training within 2 weeks. Active patient portal status upon hospital discharge increased from 44 to 66% within 12 weeks. Online patient portal conversion within 7 days after hospital discharge increased from 6.0 to 24%. Offer rate increased from 73 to 85% across all inpatient units.

Conclusion We rapidly and effectively implemented a remote proxy portal activation process in the inpatient setting. Remote activation, training, clinical decision support, multidisciplinary involvement, and emphasis on the portal as integral to ongoing care allowed us to dramatically increase portal conversion. This experience may be informative for pediatric hospitals aiming to increase proxy portal enrollment and adult hospitals with medical decision-making proxies.

Keywords

patient portal - telemedicine - pediatrics - patient engagement - patient provider communication

Authors' Contributions

All authors contributed to the writing and editing of this manuscript.


Protections of Human and Animal Subjects

This project was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects. The project was reviewed by the local institutional review board and was deemed not to be human subjects research. Quality improvement institutional review was obtained and granted.




Publication History

Received: 27 June 2020

Accepted: 28 December 2020

Article published online:
23 June 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany