Optimizing patient portal user interface boosts activation rates for Spanish-speaking pediatric patients and caregivers.

Abstract

Patient portals (PP) can enhance healthcare access for pediatric patients and families but disparities persist among patients with diverse preferred languages. Our objective was to optimize the PP user interface and associated activation workflows to improve activation rates for pediatric families with Spanish as preferred language (Spanish-speaking patients and/or parents/guardians). A quality improvement intervention at a quaternary children's hospital optimized the PP activation user interface by redesigning the email/text activation messages, activation screen and error messages. The interventions were launched on August 3, 2023. Statistical process control charts were used to analyze patterns in activation rates, PP helpdesk calls, PP before and after the intervention implementation. Of 38 575 patients with ambulatory visits in our study period, 8.4% were Spanish-speaking, 89.1% were English-speaking. There was a sustained increase in the monthly rate of newly activated PP accounts (43%-58%), decreased disparity between English- and Spanish-speaking patients by 7%, and a sustained increase in monthly rate of overall currently active PP accounts of Spanish-speaking patients (66%-69%) after interventions. There was a decrease in monthly number of helpdesk tickets due to activation issues and an increase in monthly number of incoming patient messages in Spanish per number of Spanish-speaking patients active on PP. Optimizing the PP activation user interface and workflows by applying an equity-lens can help mitigate disparities in PP access. Future research is needed to implement and evaluate health system-community partnerships to mitigate the digital health divide.