Patient Portal Helpline Outreach and Telehealth Visit Completion: A Randomized Controlled Quality Improvement Project

Patients scheduled for telehealth visits often struggle with completing these visits by the preferred means (video visit via the patient portal). This may lead to missed appointments, completion by audio-only (at lower reimbursement) and/or widening of the 'digital divide'.

We conducted a randomized controlled quality improvement project to test whether utilizing a centralized patient portal helpline to provide proactive education (vs. usual appointment support) could improve attendance of telehealth visits, completion of telehealth visits by video, and enrolment in the patient portal within 14 days before the scheduled appointment. The target population was patients at four adult primary care clinics within a large, urban municipal health system with telehealth appointments scheduled to occur between 5 August and 31 December 2024 and no active patient portal account within 14 days of their appointment. We collected outcome data on appointment completion and patient portal enrolment from the electronic health record and used chi-squared tests to compare outcomes between intervention and control groups.

We had 164 patients in the control group and 164 patients in the intervention group. There were no significant differences in visit completion between control (n = 115/164, 70.1%) and intervention (n = 121/164, 73.8%) groups (p = 0.46). Among patients who completed visits, the intervention group (n = 34/121, 28.1%) had a higher proportion of completions by video (vs. audio-only) compared with the control group (n = 18/115, 15.7%). There were no significant differences in patient portal activation within 14 days prior to and including the visit date between control (n = 50/164, 30.5%) and intervention (n = 48/164, 29.3%) groups (p = 0.81).

Health systems looking to improve telehealth video usage can consider utilizing a centralized helpline for proactive outreach and instruction to patients without activated patient portals prior to scheduled telehealth appointments, but alternate approaches are needed to improve telehealth visit attendance and patient portal enrolment.