A community health worker pilot intervention to increase patient portal use among people with HIV

Use of patient portals is associated with improved engagement in care and health outcomes in a variety of healthcare contexts including among people with HIV (PWH). However, there are disparities in portal access and barriers to portal use including lack of awareness, need for more education, and mistrust or unfamiliarity with the technology used. We investigated whether a community health worker (CHW)-led pilot initiative could increase patient portal use among PWH. Participants who enrolled in the study received help with the patient portal (MyChart) and a one-time personalized 30-minute training session with the CHW on MyChart functions. Participants reported sociodemographic information, current MyChart use, barriers, and functions of interest. MyChart utilization data were retrieved for the six months before and after the training. Descriptive statistics were used to characterize the data, and McNemar’s exact tests were used to determine significant differences between pre-training and post-training intervals (a pre-post, single-arm study design). A total of 55 participants were enrolled and trained. The majority of participants were Black or African American (94.5%), and most had Medicaid or Medicare insurance (65.5%). The most frequently used MyChart functions included viewing lab results (65.5%) and health history (60.0%), scheduling appointments (56.4%), and sending messages (54.5%). The most commonly reported barriers were lack of time (21.8%) and not understanding how to use the portal (20.0%). There was a significant increase in read/view functions (reviewing test results, reading messages, etc.) after the training (61.8% to 81.8%, p-value = 0.048). The increase in use of write/update functions (responding to messages, paying bills, updating account information, etc.) was not statistically significant (56.4% to 72.7%, p-value = 0.216). The increase in use of some MyChart functions after the training indicates the potential of CHW-led interventions to address barriers and increase portal use among PWH.Author summary: Patient portals are secure websites that allow patients to access health information and communicate with their care team. Patient portals can help patients manage their healthcare, which is important for people with HIV (PWH). However, there are challenges in making sure everyone gets the chance to sign up and use a patient portal. We wanted to see if a training led by a community health worker (CHW) could increase patient portal use. For PWH who were interested, the CHW helped them enroll in the portal (if not already enrolled) and showed them how to use it. Participants also reported information about their current portal use and any issues they experienced with the portal. We documented portal use to view test results, view health history, schedule appointments, and message care team members. One of the most commonly reported challenges was not understanding how to use the portal. We found that the CHW training was successful in increasing use of portal functions such as viewing health information and updating the electronic medical record. Our study showed that a CHW-led training has the potential to increase some patient portal use among PWH.