Embedding research study recruitment within the patient portal preCheck-in

Abstract

Objective: Patient portals are increasingly used to recruit patients in research studies, but communication response rates remain low without tactics such as financial incentives or manual outreach. We evaluated a new method of study enrollment by embedding a study information sheet and HIPAA authorization form (HAF) into the patient portal preCheck-in (where patients report basic information like allergies).

Materials and methods: Eligible patients who enrolled received an after-visit patient-reported outcomes survey through the patient portal. No additional recruitment/messaging efforts were made.

Results: A total of 386 of 843 patients completed preCheck-in, 308 of whom signed the HAF and enrolled in the study (37% enrollment rate). Of 93 patients who were eligible to receive the after-visit survey, 45 completed it (48% completion rate).

Conclusion: Enrollment and survey completion rates were higher than what is typically seen with recruitment by patient portal messaging, suggesting that preCheck-in recruitment can enhance research study recruitment and warrants further investigation.

Keywords: HIPAA authorization form; patient portal; preCheck-in; research study recruitment; survey.

Figure 1.

Comparison of preCheck-in recruitment to synchronous and asynchronous patient portal secure messaging recruitment. ^aThis report describes an asynchronous application of preCheck-in recruitment for survey-based research, though this framework could be modified to mimic synchronous enrollment (ie, administering the survey simultaneously with the HAF during pre-Check-in) or for use in clinical trial or voluntary research registry recruitment. ^bA commonly utilized workflow for survey-based research, though some studies do collect surveys asynchronously from the time of HAF completion. ^cA commonly utilized workflow for clinical trial recruitment through the patient portal. preCheck-in recruitment could theoretically be adapted to replace steps 1–3. ^dClinical encounter does not need to be related to the research study (ie, occurring regardless of any research activity). ^eThese steps trigger a generic notification to be sent to a patient’s personal email asking that they log in to the patient portal. Notification emails do not contain links to surveys; these can only be accessed by logging into the patient portal. ^fCalculated as the number of patients who signed the HAF divided by the number of patients who received the HAF. ^gCalculated as the number of patients who responded to the communication (eg, secure message, survey) divided by the number of patients who received the communication. Abbreviations: HAF: HIPAA authorization form.

Figure 2.

Patient portal screenshot of new preCheck-in process for HIPAA authorization form (HAF) completion and study enrollment. Red boxes outline the newly created “Sign Documents” tab and HAF. Prior to the modification the “Sign Documents” tab was absent, and the remainder of the preCheck-in process was unchanged. The myUCLAhealth App is poweredby MyChart^® licensed from Epic Systems Corporation, © 1999–2023.

Figure 3.

Cohort flow diagram. The PROM used as the after-visit survey was the PROMIS-29 + 2. See the Materials and methods regarding eligible encounter types and ICD-10 codes. Abbreviation: PROM, patient-reported outcome measure.