Staying on top of diabetes management can be challenging for patients, so Vanderbilt researchers found a way to reduce potential gaps in care: better use of the patient portal.
S. Trent Rosenbloom, M.D., M.P.H., of Vanderbilt University Medical Center (VUMC), and colleagues are helping patients through refined use of the medical center’s My Health at Vanderbilt portal – one of the longest running such patient access points in the United States.
The My Health portal was launched in 2004. By June 2023, the site had registered more than 1 million users.
“It is integral to how we deliver care at Vanderbilt,” said Rosenbloom, the site’s clinical director who also recently received the American Academy of Pediatrics’ Byron Oberst Award for contributions to the field of pediatric clinical informatics. Rosenbloom directs and helps curate information for Vanderbilt’s online portal.
How Patients Experience the Patient Portal
Multiple studies led by researchers within the My Health at Vanderbilt online community have informed this approach to optimizing benefits of the patient portal. In one recent study led by Lyndsay A. Nelson, Ph.D., the researchers found that the use of patient portals can be hindered by several factors, among them patient distrust of the automated system, concerns about the site’s content, and frustration over navigation.
Findings from this study suggest that improvements to the patient portal could increase its usability by patients in a number of ways, including notifications for patients about doctor’s instructions or clearer language on when to seek care.
Optimizing for Diabetes Care
My Diabetes Care is a component of My Health at Vanderbilt specifically designed to aid patients with diabetes self-management.
The team at My Health at Vanderbilt continues to investigate ways to improve diabetes care delivery through the portal. Rosenbloom’s VUMC colleague, William Martinez, M.D., M.S., and his team developed the My Diabetes Care dashboard.
Patient-driven self-management is a critical part of diabetes care, but it remains complicated for patients.
“Having tools to support patients as they self-manage their diabetes can be really powerful,” Rosenbloom said.
To test that theory, the researchers have been examining ways to make the experience even better.
“A number of us over the past few years have really been trying to take a bite out of that question and build different tools that are integrated into the patient portal and into their lifestyle to help them self-manage their disease,” Rosenbloom said.
“Having tools to support patients as they self-manage their diabetes can be really powerful.”
The portal is a fast way for physicians and others to send out basic reminders and educational materials to patients, he said. The dashboard features infographics and even offers a gamification tool that compares an individual’s levels of diabetes control to that of other participating patients.
The also portal offers real-time delivery of test results and other medical information. Rosenbloom explained this can be particularly important for patients with diabetes, who typically have greater-than-average requirements for testing, appointments, and medication refills.
“They’ve got a lot of additional self-management that they need to do, and the portal brings all that together into a single place for them,” Rosenbloom said.
Recently, the group completed a study led by Martinez exploring the impact of the My Diabetes Care dashboard on patient activation.
The team is still evaluating its outcomes, however, “we know it has substantially improved satisfaction and sense of empowerment among patients with diabetes,” Rosenbloom said.
“Having what we call health-data transparency, where everything is available to patients in real time, really makes them feel trusted and empowered to manage their care,” he explained.
Future Innovations
Looking forward, Rosenbloom said the team may consider adding greater integration with lifestyle tools, such as dietary surveys and step counters. He also envisions the potential for such a system to communicate glucose monitor readouts and other information electronically to the patient’s EHR and care team.
“Having what we call health-data transparency, where everything is available to patients in real time, really makes them feel trusted and empowered to manage their care.”
Rosenbloom said much of what their team has accomplished could also be implemented at other health systems.
“Increasingly, electronic health record systems are being built to allow chronic disease management across diseases, and so it becomes easier for other health systems to build in these kinds of tools,” he said.
