High Tech and High Touch (HT2): Transforming Patient Engagement Through Portal Technology at the Bedside

The appropriate use of technology to actively engage with patients who suffer from multiple
chronic conditions, called multimorbidity, is one of the frontiers of both research and
practice. For multimorbid patients, engagement in disease management activities is
particularly critical, and evidence shows that enhanced patient self-management can lead to
better control of chronic illness. One tool finding increasing use is the patient portal, and
its pervasiveness is supported by virtue of its role as a component of the Meaningful Use
criteria. A patient portal is a tethered personal health record (tPHR) that links to the
patient's electronic health record, facilitating communication and engagement activities with
healthcare providers. While most tPHRs have been focused on outpatient activities, a new
class of tools focused on the inpatient experience has begun deployment in 2014.

In response, this study supports the conduct of the first, large-scale randomized control
trial (RCT) of the impact and use of an inpatient tablet-based patient portal embedded in a
larger mixed methods study to examine changes in patient experiences and outcomes, and
subsequent ambulatory patient portal usage. The investigators aim to study how access to a
patient portal tailored to the inpatient stay can improve patient experience and increase
patient engagement by improving patients' perception of the process of care while in the
hospital (patient experience), increasing patients' self-efficacy for managing their chronic
conditions (patient engagement), and facilitating use of a patient portal for care management
activities after discharge (patient engagement).

The study site is a world-class healthcare facility with the ability to provide access to a
patient portal designed specifically for the inpatient experience, bridging to outside the
hospital after discharge.

Currently, this inpatient technology exists in only one other hospital in the US, but the
investigators expect that as inpatient PHRs become more readily available, the need for
clarity on this issue will only increase. The investigator's evaluation is a mixed-methods
design consisting of primary data collection through surveys and interviews throughout the
study period, and secondary data collection from the electronic health record and health
system metadata. This study will offer insight into a potentially important mechanism to
facilitate patient self-management.

Inclusion criteria:

- 18 years or older

- inpatient

- capable of providing informed consent

Exclusion criteria:

- prisoner

- legally blind

- cannot speak and read English

- involuntarily confined or detained

- have a diminished decision making capacity