Intensive Remote Onboarding to Improve Digital Health Access Among Safety-Net Patients During a Pandemic: An...

Area of Science:

• Digital Health
• Health Equity
• Patient Engagement

Background:

• The COVID-19 pandemic highlighted and worsened disparities in digital health access.
• Patient portals are crucial for modern healthcare delivery.
• Safety-net patients often face unique challenges in accessing digital health tools.

Purpose of the Study:

• To assess the feasibility of a remote onboarding workflow for enrolling safety-net patients onto a patient portal.
• To identify barriers and facilitators to patient portal enrollment among this population.

Main Methods:

• A standardized remote workflow was developed to assess patient interest and provide technical support for portal enrollment.
• Initial outreach targeted English-speaking adults with enrollment codes.
• Expanded outreach included Spanish speakers and patients without codes, utilizing video identity verification.

Main Results:

• 49% of contacted eligible patients were reached.
• 62% of reached patients expressed interest in enrollment.
• Only 20% of interested patients ultimately enrolled.
• Key barriers included lack of smart devices, internet access, and videoconferencing familiarity.

Conclusions:

• Safety-net patients demonstrate significant interest in patient portals.
• Current remote onboarding workflows face substantial obstacles for this population.
• Health systems require enhanced, inclusive strategies and resources for equitable digital health onboarding.