Patient Engagement: The Impact of Electronic Patient Portal Use on Missed Appointments in Patients with Diabetes, a Retrospective Study

Background: This retrospective observational chart review evaluated the use of the MyChart® patient portal as a viable tool for engaging patients. Engagement was measured as fewer missed appointments (no-shows and same-day cancellations). Objectives: To determine who uses the MyChart® patient portal in a chronically ill population of adult patients with diabetes and assess the association of portal use with missed appointments. Methods: The medical records of adult patients (18-80) with a diagnosis of Type 1 and/or Type 2 Diabetes Mellitus (DM) were reviewed (N=7,795). The efficacy of the MyChart® patient portal at reducing missed appointments was assessed by comparing patients who use the portal (evidenced by two or more log-ins during the study period) to those who do not. Results: In this study, 43.7% of adult patients with diabetes used a portal account. Portal users were predominantly female, non-Black, married, non-smokers, and had at least one of the comorbidities often associated with diabetes (hypertension, hyperlipidemia, and/or obesity). Portal users were on average 58.8 years old. Use of the MyChart® patient portal was independently associated with a reduced no-show rate (4.7% for portal users compared to 12.4% for nonusers). However, when patients who activated a portal account during the study period were subjected to a within-subjects analysis, the mean missed appointment percentage was not statistically significantly different when patients had an activated portal account compared to when they did not. Thus, the portal may be a useful tool for engaging chronically ill patients but it is only one component to appointment arrivals. Conclusion: Conclusions from this study are limited given the retrospective design. Nonetheless, the findings suggest that the patient portal is effective at engaging chronically ill patients and thus warrants greater merit. The portal may also be a useful tool for reducing missed appointments in patients with chronic illness who would greatly benefit from appointment adherence. Future research should focus on testing the hypotheses generated in a prospective manner