Bridging the Gap: Portal Messages as a Tool to Improve Breast Cancer and Diabetes Screening Rates.

Abstract

Healthcare systems use electronic patient reminders to encourage preventive care receipt. We used an innovative randomized testing approach to identify reminder design elements associated with improved patient responsiveness. Improve patient response to electronic preventive care screening reminders. Outpatient clinics affiliated with NYU Langone Health (NYULH) and their patients. Included patients were due for retinal, hemoglobin A1c (HbA1c), or mammography screening. Iterative EHR reminder redesign using a behaviorally informed framework, testing improvements based on randomized implementation. We randomized patients for each screening type to intervention (redesigned) or control (existing) reminders. Outcomes were scheduling or completion of indicated test. Plan-Do-Study-Act Cycle #1 tested all three redesigned reminders. Cycle #2 tested a personalized reminder versus the redesigned mammography reminder from Cycle #1. Cycle #1: Redesigned mammography reminders showed greater adherence (25/212 [11.8%] vs. 13/212 [6.1%]) compared to controls (p = 0.04). Redesigned retinal and HbA1c reminders showed no difference. Cycle #2: Scheduling adherence for mammography was similar for personalized and non-personalized reminders (p = 0.68). Iterative, randomized testing of re-designed electronic preventive care reminders was feasible within a large, complex healthcare system and showed the value of brief messages with a scheduling link for mammography.