Understanding Patient Engagement in a Primary Care Setting: A Patient Health Portal Quality Improvement Project

To comply with Meaningful Use (MU), Millcreek Primary Care (MCPC), a primary care clinic affiliated with St. Mark's Hospital in Utah, initiated eClinicalWorks Patient Health Portal (eCW). Stage 2 of MU mandates 5% of patients adopt the electronic health record (EHR) through engagement by secure messaging with providers and viewing their personal health information through the portal. MCPC met Stage 2 MU goals, however the providers had concern patients were not experiencing the benefits of portal engagement based on portal use data. Our research question is: What motivating factors influence the patients' behaviors to use health information technology (HIT)? To investigate the motivating factors influencing patients use of HIT, we conducted a survey based on the Health Information Technology Acceptance Model (HITAM) in a primary care clinic (N = 98) of patients who were registered (N = 64) or not registered (N = 29) with eCW. The independent t-Test indicated no statistical difference between the two groups of participants regarding the HITAM motivating factors (p values ranged from .263 to .886). All participants data were used to assess correlation coefficients between motivating factors from the HITAM. The results revealed moderate to strong positive correlations between "intention to use" and the following HITAM factors (p < .001): "attitude" (r = .81), "perceived usefulness" (r = .77), "HIT reliability" (r = .73), "HIT self-efficacy" (r = .71), "perceived ease of use" (r = .65), "subjective norm" (r = .52), and "health beliefs/concerns" (r = .43). Based on the findings, strategies to engage patients with the eCW portal, should focus on enhancing patients' positive attitude, the usefulness and reliability of eCW, and patients' self-efficacy.