In-hospital enrollment into an electronic patient portal results in improved follow-up after orthopedic surgery: Inpatient enrollment into electronic patient portal (Preprint)

Abstract

Electronic patient portal (EPP) use is associated with lower no-show rates and increased patient satisfaction. However, there are disparities in enrollment into these communication platforms.

We hypothesized that guided inpatient enrollment into an EPP would improve clinical follow-up and EPP use rates for orthopaedic surgery patients compared to the usual practice of providing information in the discharge summary.

We performed a randomized controlled trial of 229 adult patients who were admitted to the hospital for an orthopedic condition that required a three-month follow-up visit. Patients were cluster randomized by week to either the control or intervention group. The control received information on how to enroll into and use the EPP in their discharge paperwork, while the intervention was actively enrolled and taught. At 3 months post-discharge, patients were followed to see if they attended their follow-up appointment or used the EPP.

83% of patients presented for follow-up at 3 months (80.2 vs 85.8, control vs intervention, P=0.25). Likelihood of EPP use was significantly higher in the intervention group (16.4% vs 62.0%; OR 8.3, 95% confidence interval = 4.5, 15.5; P<0.001). Intervention patients who used the EPP were more likely to present for post-surgical follow-up (OR 3.59, 95% confidence interval = 1.28, 10.06; P = 0.015).

Inpatient enrollment of orthopaedic surgery patients into an EPP increased EPP use, but this did not independently result in enhanced follow-up. Patients who were enrolled as inpatients and subsequently used the portal had the highest likelihood of 3-month follow-up.

ClinicalTrials.gov Identifier: NCT03431259