Improving Diabetes Care Through Effective Personalized Patient Portal Interactions

Currently over 3 million Veterans have adopted the VA Patient Portal, My HealtheVet (MHV),
however actual use of the portal varies considerably, and the investigators have little data
on how the portal features can best improve patient outcomes, or whether effective use varies
by subgroups. By examining the patient portal features associated with improved outcomes and
clarifying how patients can best leverage these features to better manage their diabetes, the
investigators will develop and test an intervention to improve adoption and use of the
patient portal for diabetes management. The goal of this small scale study, using a
randomized encouragement design, is to test the feasibility of engaging Veterans in a
supported adoption intervention to promote effective MHV use, in a sample of Veterans with
diabetes (with or without comorbid mental health problems).

The investigators will recruit from Veterans at the study sites who have uncontrolled glucose
(HbA1c >= 9%) and have not used the patient portal. Participants will be randomized to one of
two conditions: 1) Encouragement and 2) Comparison. Participants randomized to the
encouragement arm will receive a mailing to emphasize the importance of setting health goals
and explain how MHV can help and will have the opportunity to participate in the Supported
Adoption intervention. Those in the intervention will receive a one-on one session (to sign
up and learn how to use secure messaging), a group training session (which will emphasize the
features most meaningful for diabetes management) , and follow-up support after the training
sessions to provide further encouragement. Those in the comparison condition will receive a
mailing with only the goal setting content (no MHV nor intervention component offer).

Inclusion Criteria:

- Veterans

- Hemoglobin A1c result >=8.5% at most recent lab test prior to recruitment

- Non use of the VA patient portal, defined by not being registered or registered with
no recent activity

- Currently being seen at one of the sites participating in the study

- Ability to provide informed, voluntary, written consent

Exclusion Criteria:

- Non-Veterans

- Controlled hemoglobin A1c levels (A1c<8.5%) at most recent lab test prior to
recruitment

- Recent use of the patient portal

- Psychiatric diagnosis that would limit participation

- dementia

- evidence of active, severe psychotic symptoms