A description of the development and initial evaluation of a patient navigator delivered patient portal enrollment...

Uptake of electronic patient portals is low in underserved populations. Federally qualified health centers (FQHCs) face unique barriers, including limited digital literacy, language differences, and low trust in technology. This paper describes the development and initial evaluation of a patient navigator program aimed at increasing portal enrollment in three FQHC locations.

Development and implementation followed a seven-step process guided by the Knowledge to Action Framework: (1) stakeholder engagement to identify barriers, (2) literature review to contextualize disparities, (3) resource and workflow assessment, (4) stakeholder feedback to refine the navigator approach, (5) a monitoring system to track enrollment and navigator activities, (6) identification of structural barriers and sustainability strategies, and (7) project evaluation. Navigators were embedded in clinic workflows to assist with MyChart enrollment, provide technical help, and address concerns. Activation rates were assessed with pre-post comparisons and navigator tracking data.

Tailored materials, including a MyChart handout and a smaller flyer for login details, were created. Over 12 months, of 1658 eligible patients, 1062 (64 %) accepted navigator assistance; 790 (74 %) successfully activated MyChart. African American (44 % to 49 %) and Latinx (52 % to 60 %) patients showed notable gains, and nearly all (99 %) newly enrolled users accessed MyChart at least once post-activation.

Embedding navigators proved feasible for increasing MyChart enrollment in FQHC settings. The structured process highlighted essential considerations for scalability. Future work should examine long-term sustainability and how patient navigation affects broader engagement and health outcomes.

By offering real-time, culturally attuned support, navigators can help patients overcome digital literacy barriers, thereby improving enrollment in patient portals. Health systems seeking to reduce disparities may benefit from adopting navigator-led strategies as part of routine care.