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

ABSTRACT

Purpose/Objectives: To describe the rapid implementation of remote patient portal activation in a pediatric integrated delivery network during the initial phase of the COVID-19 pandemic. We sought to increase the percentage of patients with active portal status upon discharge by 15% (absolute change) across inpatient units within 3 months. Design/Methods: A multidisciplinary taskforce utilized QI tools (fishbone diagram, process map) to identify barriers to successful inpatient patient portal activation. PDSA cycles included rapid cycle training of the remote MyChart enrollment workflow for hospital unit clerks (HUCs), increased patient education about portal functionality, standardized portal enrollment workflow across all inpatient units, and improved visibility of portal status for clinical staff and HUCs. The primary measure was the percentage of admitted patients with active MyChart status upon discharge. Baseline data was collected retrospectively via Epic Reporting Workbench. A patient portal activation dashboard was used to monitor progress on a weekly basis. We used statistical process control charts to examine the impact. Results: We completed training and clinical decision support tools (Unit Manager view and MyChart® status Epic column) creation within 2 weeks from the start of the initiative. Active online patient portal status upon hospital discharge increased from 44% to 66% (a 22% absolute increase) within 12 weeks. The process demonstrated a consecutive upward trend of 5 or more data points, consistent with special cause variation at the end of April 2020. During the same time period, the percentage of online patient portal activation within 7 days after hospital discharge increased from 6.0% to 24%, and the patient portal offer rate increased from 73% to 85% across all inpatient units. Conclusion/Discussion: 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 activation.