2016 patient engagement satisfaction survey results · surveymonkey on behalf of providers whose...

ARKANSAS MEDICAID PATIENT ENGAGEMENT SURVEY

2016 Patient Engagement Satisfaction

Survey Results

2016 Patient Engagement Satisfaction

Survey Results

TABLE OF CONTENTS

Contents Executive Summary ........................................................................................................................ 3

Beneficiary Survey Results ........................................................................................................... 11

Beneficiary Survey Overview and Methodology ..................................................................... 13

Demographics of Beneficiary Survey Sample and Population ................................................. 15

Patient Portal Access and Use by Beneficiaries ....................................................................... 17

Reported Uses of the Patient Portal .......................................................................................... 19

Frequency, Ease of Use and Satisfaction with Internet and Portals ......................................... 21

Does Use of Patient Portals Correlate with Internet Access and Use? ..................................... 23

Beneficiaries Inclination and/or Barriers to Use ....................................................................... 25

Demographic Analysis .............................................................................................................. 27

Internet- and Health-Related Information ................................................................................. 31

Beneficiary Survey – Frequency Tables ................................................................................... 33

Appendix A - Letters and postcard ............................................................................................... 51

Appendix B - Beneficiary Survey tools ........................................................................................ 57

Provider Survey Results ................................................................................................................ 79

Provider Survey Overview and Methodology .......................................................................... 81

Provider / Practice Characteristics and Portal Use ................................................................... 83

Provider / Practice Experiences with the Portal ........................................................................ 85

Provider Survey - Frequency Tables......................................................................................... 91

Appendix C - Provider Survey Tool ............................................................................................. 95

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The Arkansas Department of Human Services’ (DHS) Division of Medical Services (DMS) contracted with AFMC, a National Committee for Quality Assurance (NCQA) certified Healthcare Effectiveness Data and Information Set (HEDIS®

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1) survey vendor, to conduct its 2016 Patient Engagement Satisfaction Survey. The Arkansas Medicaid program plans to develop patient engagement strategies to increase the use of health informational technology (HIT) and patient portals by the state’s Medicaid population. A patient portal is a secure online website that gives the consumer convenient 24-hour access to their personal health information from anywhere with an internet connection. These technologies, particularly when integrated with an electronic health record (EHR), have the potential to improve both quality and access to care through features that enable patients to communicate electronically and securely with their provider, access their medical records, schedule appointments, pay bills, and refill prescriptions. The 2016 Patient Engagement Satisfaction Survey included two parts: a patient survey and a provider survey. The patient satisfaction beneficiary survey was mailed to 8,007 beneficiaries with equal representation from ConnectCare, ARKids First A and B, and the private option health plans. The provider satisfaction survey was emailed to 1,190 health care providers via SurveyMonkey. This report provides a summary of the 2016 survey results and will assist DMS in developing strategies to improve health care through technology. Background As part of its contract with DMS, AFMC regularly surveys Medicaid beneficiaries about their health care experiences. This survey regarding access and use of health care technology by Medicaid beneficiaries and Arkansas health care providers is the first survey of its kind conducted by AFMC. The beneficiary survey asked questions about access to patient portals, frequency of use and experience. For individuals who responded that their health care provider offered a patient portal but they have never tried to access it, the survey asked about the reasons for not doing so. The survey also collected information about the general availability and use of technology other than patient portals (whether or not they had access to the internet and what type of internet connection). Furthermore, the survey inquired about the use of internet by Arkansas Medicaid beneficiaries to search for health care-related information. Since it is equally important to understand patient portal use by health care providers and barriers to use if any, an online survey via Survey Monkey was sent to 1,190 providers for their input regarding their use of and experience with this technology. Response rate Per NCQA guidelines, 8,007 beneficiaries were selected from Arkansas Medicaid Management Information System (MMIS) data. The final sample size included 2,000 ConnectCare, 1,995 ARKids First A, 2,003 ARKids First B and 2,009 Private Option beneficiaries. A total of 1,357 surveys was received, resulting in a cooperation rate of 16.9 percent. After further exclusion of bad addresses and survey recipients who no longer met eligibility criteria, the analyzable sample size was 6,639.

1 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

Executive Summary

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Analyzable surveys were considered complete and valid if they were received and the beneficiary had answered at least one question on the survey. A total of 1,354 complete and valid surveys were available for analysis resulting in an analyzable rate of 20.4 percent. On March 22, AFMC sent out an email to invite 1,190 provider contacts to take the survey via SurveyMonkey on behalf of providers whose name was listed on the accompanying email. The survey consisted of 17 questions and as of April 12, 230 contacts had responded. The cooperation rate was 19.3 percent. Fifty provider contacts (4.2%) opted out of receiving surveys via SurveyMonkey. Excluding email addresses that bounced, the analyzable sample size was 1,145. A total of 215 surveys were complete and valid resulting in an analyzable rate of 18.8 percent. Table 1: Sample size and response rates

PES16 Survey Beneficiary Survey

2016 Provider Survey

2016

Survey sample size 8,007 1,190

Total surveys returned 1,357 230

Cooperation rate 16.9% 19.3%

Analyzable sample size* 6,639 1,145

Analyzable surveys 1,354 215

Analyzable rate 20.4% 18.8% * also excludes bad addresses/bad emails Key findings The following is a summary of the results for the beneficiary survey:

Demographics Demographically, the survey sample was significantly different from the population in most

categories. This was a result of using a minimum required sample size of 2,000 from four distinct populations that varied significantly in size.

The analyzable survey sample was not demographically very different from the survey sample. The respondents of the patient engagement survey were predominantly female (54.7%) and

white (56.6%). Differences between survey sample and the population by age, although statistically

significant, are not very substantial, with the largest difference of 3.6 percent noted in the age category of “18–24” and the smallest difference of 0.3 percent in the “55 or older” age category among the adult beneficiaries.

Comparing the child population (ARKids First A and B) with the child sample, the largest difference is in the age category of “13–18,” with a significantly larger representation of this age group in the sample as compared to the population.

Patient portal access and use by beneficiaries Regardless of Medicaid plan type, the majority of respondents indicated that their provider did

not offer patient portals or that they were unaware. While exploring by Medicaid plan type, no statistically significant differences were noted for

patient portal access or use.

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51.3 percent of 158 respondents indicated that they access the portal via a home computer or laptop and more than a third access it via a personal mobile device.

When comparing by demographics of respondent, survey respondents ages 18 and under constituted 7.4 percent of the total respondents, with only 4.8 percent of those having access to and only 1.1 percent of those using the patient portal. While respondents ages 18–34 constituted 28.3 percent of the total survey respondents, that age group made up over a third of the number of respondents that have used the portal.

Females are more likely to report using the patient portal but less frequently than males. Similarly, whites and respondents who indicated their education level as “Some college” were most likely to report using a portal.

Reported uses for the patient portal 62.7 percent of respondents use the patient portal for office visit summaries and for viewing lab

tests and results Less than 10 percent of the respondents use patient portals for making payments, asking billing

questions and educational materials 38.6 percent indicated viewing lab tests and results was the most valuable use of the portal,

followed by 17.5 percent selecting office visit summaries as the most valuable use Less than five percent selected “ask billing questions,” “request referrals” and “make payments”

as the most valuable use of the portal

Frequency, ease of use and satisfaction with internet and portals More than half of the 47 private option respondents reported using the portal at least once a

month or more, while only 26.8 percent of the ARKids First B parents reported using the portal as frequently

A larger proportion of the child Medicaid and CHIP respondents have access to internet all/most of the time compared with the ConnectCare and private option adults

The respondents for the child plans (ARKids First A and B) were also more likely to have email addresses and go online at least once every week

More than 75.0 percent of respondents representing beneficiaries from each Medicaid plan type seem to be “Very satisfied” or “Somewhat satisfied” with using the portal

54.2 percent of the 24 respondents who indicated that they were “Somewhat dissatisfied” or “Dissatisfied” with using the portal feel the portal is not very user friendly, and 16.7 percent indicated they would need help or education on using it

Beneficiaries’ inclination to use the portal if they could have access 518 out of 770 (67.3%) responded that they would be inclined to use it if they were able to access

medical records, immunization records, check lab results, make appointments, request refills, make payments or address medical concerns

The adult beneficiaries covered under the traditional Medicaid program were the least inclined, with only 58.5 percent showing an inclination to use patient portals

Beneficiaries’ barriers to use even though they have access to portal through provider 31.4 percent of 242 respondents are not interested in accessing their records electronically 25.6 percent do not have access to the internet or a computer 22.7 percent are concerned about online privacy and security

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Internet and health-related information Less than a quarter of all respondents (21%) use the internet to research health care information

for the beneficiary Of the 276 who use the internet for health care information, 185 (67.0 percent) indicated that they

discuss that information with the health care provider of the beneficiary

The following summarize the results for the provider survey:

Provider/practice background 67.0 percent of respondents describe their practice as a solo practice or a small group practice (2–

7 physicians) 71.2 percent of respondents say the majority of the care they provide is primary care 67.0 percent of respondents practice in communities of more than 10,000 people 69.3 percent of respondents see fewer than 301 patients each week 86.0 percent of respondents have achieved Meaningful Use (MU) or are working on achieving

MU of certified EHR technology

Portal use by practice characteristics Smaller practices with no more than seven physicians (66.0%) are less likely to use a patient

portal than large groups or hospital-affiliated groups (90.1%) 79.7 percent of primary care respondents use a patient portal in their practice Practices that see more than 100 patients per week (82.0%) are more likely to use a patient portal

than practices that see fewer than 100 per week (50.0%)

Provider/practice experiences with the portal 47.1 percent of respondents use an outside support vender to support their portal 73.9 percent of respondents indicated using their patient portal for clinical summaries 64.1 percent of respondents selected “Ease of sharing information with patients in a timely

manner” as being useful/beneficial 49.7 percent of respondents say they have measured improvements in the “Access to clinical

summary” from the use of the patient portal 45.0 percent of respondents say their clinicians have access to the portal through their mobile

devices

Patients’ education regarding the portal 68.6 percent of respondents indicated that clerical/front desk staff recommend the use of their

patient portal to patients 86.9 percent of respondents offer verbal instructions on educating patients about their patient

portal 83.0 percent of respondents offer assistance in registering patients on their patient portal

Obstacles for current users 80.1 percent of respondents indicated their patients’ not using technology was an obstacle in their

use of a patient portal

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64.9 percent of respondents identify their patients’ not having access to technology as being an obstacle

Barriers for non-users to initiate the portal

51.9 percent of respondents indicated the expense for the practice (equipment) as being a barrier for initiating the use of a patient portal

42.6 percent of respondents indicated that time constraints and technical support were barriers in the initiation of portal use

Conclusions Both beneficiary and provider portions of the 2016 Patient Engagement Satisfaction Survey assessed the interest, access and use of patient portals in Arkansas. Within the beneficiary survey, questions addressed access to patient portals, frequency of use and experience. For the provider survey, questions addressed patient portal usage, patient portal education to their patients, benefits of portal usage and what may be keeping practices from initiating the use of a patient portal. Analysis also included careful consideration of characteristics and demographics of patients, practices and communities.

A large proportion of beneficiary respondents indicated that their provider did not offer patient portals or that they were unaware even though the majority of responding providers indicated they had a portal. We do not know the level of patient portal implementation for non-responding physicians, and it is very likely that providers who have implemented patient portals were the ones that responded to the survey. The majority of patients who used the portal found it easy to use and were satisfied with using patient portals. For individuals whose provider does not offer a patient portal, inclination to use a patient portal varied by type of medical plan of the respondent.

Access and use of technology in general varied by demographics of the patient survey respondents. One interesting finding is that demographic groups who indicate highest access to the internet and technology were not necessarily the ones with the highest use of patient portals. For example, a higher proportion of females reports the most access, while a higher proportion of males indicates use of the portal at least once a month. The same is true for education and race.

Portal implementation also varied by provider – smaller practices were less likely to implement a patient portal.

The main barriers to using the patient portal indicated within the beneficiary survey included lack of interest, internet/computer access and privacy concerns. Obstacles for current providers using patient portals included patients’ lack of use and access to technology. For providers who are not current users of patient portals, barriers for implementation included expense for equipment, time constraints and lack of technical support.

Limitations One limitation of both beneficiary and provider surveys was that respondents self-reported answers, so the results may not reflect the actual use of a patient portal and may be subject to recall bias.

From beneficiary survey responses, we do not know the health status of the beneficiary or their access to the health care system in general and whether this plays a role in their use or non-use of patient portals.

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For non-responding physicians we do not know the level of patient portal implementation. Also, the respondents are clinics that have been associated with AFMC’s outreach department and, therefore, a convenience sample was surveyed and is not representative of the whole state’s providers. Hence, the results cannot be generalized to the whole provider population in the state or to other states. Given the questions received by AFMC staff over the phone regarding the survey, it is unclear whether beneficiaries felt they were eligible to fill out the survey. AFMC staff talked to several beneficiaries who indicated that they received the surveys in error because they did not know what a patient portal was or have access to the internet. Those who called were encouraged to fill out the survey anyway. However, if others who received the survey felt the same way and did not contact AFMC with questions, it may have affected the response rate. As per NCQA 2016 guidelines, AFMC applied the systematic sampling method when generating the sample for this survey using a minimum required sample size of 2,000 from each distinct Medicaid population group. This may have led to an over representation of the adult Medicaid and CHIP populations in the survey respondents and underrepresentation of the child Medicaid and private option beneficiaries. A large proportion of beneficiary respondents indicated that their provider did not offer patient portals or that they were unaware even though the majority of responding providers indicated they had a portal. However, the survey responses on the provider survey could not be linked to beneficiary responses directly. Further exploration of matched beneficiary and provider responses may be warranted. Recommendations Utilize AFMC health IT and provider representatives to further assess the adaptation of portals in

Arkansas by reaching out to clinics that did not respond to the provider survey. Include questions in future surveys that address overall health and utilization of services (CAHPS) to

determine whether use of the health care system or health status affects patient portal use. Conduct focus groups to better understand beneficiary and provider needs for education or experience

with portals. Those clinics already using a patient portal and desiring a greater percentage of participation with

their portal may find recommendation and encouragement of its use by a nurse or physician a meaningful tactic with a demonstration of portal features that may interest the patient most. The majority of clinics indicated that front desk or office staff recommend portal use, but patient respondents who were using the portal indicated that it was recommended by their physician.

Technical assistance throughout practices is necessary to gain and keep provider participation. The ongoing MU technical assistance is directly related to helping providers attain MU and receiving EHR incentives. The incentive payments could help offset the cost of a patient portal (since this was a concern of some practices). AFMC’s health IT department can assist in these efforts as a liaison between providers and EHR vendors to assist providers with any needs. Increased access for technical support for patient portals will aid in further implementation.

Support smaller clinics and provide hands-on training for those clinics to increase portal implementation.

Develop infographic brochures that could be shared with providers to upload to their portals and increase interaction with patients.

Utilize survey results to develop practice and beneficiary educational tools to build trust in the use of health information technology and increase patient use of technology.

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o Educational tools demonstrating best practices for physician and office staff to support patient and family engagement strategies

o Beneficiary-focused educational and training tools to be used by the AFMC outreach team at beneficiary training events. These tools may also be utilized in clinics to enhance beneficiary training and education.

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Beneficiary Survey Results

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Beneficiary Survey Overview and Methodology Sampling frame

The beneficiary data were obtained from MMIS. As per NCQA 2016 guidelines, the sampling methodology for HEDIS/CAHPS surveys no longer employs a simple random sampling method. Instead, a systematic sampling method is now being used for all CAHPS/HEDIS surveys beginning in 2016. AFMC applied the systematic sampling method when generating the sample for this survey using a minimum required sample size of 2,000 from each distinct population group, an oversampling rate of one percent (to account for bad addresses and duplicate households) and a RAND (random number) of 0.4. The resulting sample size was 8,055, and after flagging for duplicate households, a total of 8,007 surveys were mailed out. For the provider survey, a list of unique email IDs was generated from AFMC’s provider contact list in the Salesforce customer relationship management (CRM) system. The online survey via SurveyMonkey was sent to 1,190 provider contacts for input regarding patient portals and using technology in their practice. The email addresses were for office staff, and each individual was asked to complete the survey on behalf of a provider within their clinic so that the responses would be based on the provider’s perspective. Survey procedure and timetable

An advance letter, written on DMS letterhead and signed by the director of DMS, was mailed to each selected Medicaid/private option beneficiary (Appendix A). The letter explained the purpose of the survey, informed the beneficiary of its confidential and voluntary nature, and gave information on requesting a Spanish-language version of the survey. Approximately 10 days later, a packet was sent to the beneficiary containing a questionnaire (Appendix B), a postage-paid return envelope and a cover letter. The cover letter, on DMS letterhead and signed by the director of DMS, reiterated the information in the advance letter and gave specific instructions on completing and returning the survey (Appendix A). A reminder postcard was mailed 10 days later to those beneficiaries who did not respond (Appendix A). Approximately one month after the initial survey was sent, a second survey was mailed to any beneficiary who had not returned a survey. A second reminder postcard was mailed 12 days after the second survey. All mail was sent bulk rate with return receipt and address correction requested, and letters and surveys that were returned as undeliverable with an address correction were re-mailed. Telephone follow-up of non-respondents was not performed. Table 2: Survey timetable Survey mailings Date

Advance letter February 22

First survey March 11

First reminder postcard March 21

Second survey April 07

Second reminder postcard April 18

Data collection cutoff May 09

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Survey tracking A unique number was assigned to each survey for tracking purposes only. This tracking number was used so that a second survey could be mailed to non-responders but not to those who had already completed and returned the survey. Beneficiary confidentiality was never compromised. Disqualified surveys

Surveys received after the data entry cut-off date of May 9 were excluded from the survey analysis. Surveys without any valid responses and a note stating that they were not eligible were excluded from the analysis. Only two surveys were excluded by this definition. Total excluded or disqualified surveys represented 0.1 percent of the total surveys received. A blank survey was treated as a refusal. Several beneficiaries called in with questions regarding their eligibility for the survey since they were not aware of patient portals or did not have access to a computer or the internet. AFMC staff requested that the beneficiaries who called still complete the survey. However, there may be other beneficiaries who did not call in and did not complete the survey who also assumed that they were not required to do so if they did not have a computer or access to the internet. Non-analyzable surveys A total of 6,653 surveys was not returned or available for analysis. AFMC tracked the reasons why these surveys were not returned or were ineligible for analysis following NCQA guidelines. Table 3: Non-analyzable surveys Non-analyzable Surveys 2016

Incorrect address 1,357

No response after maximum attempts 5,275

Beneficiary refusal 10

Beneficiary deceased 2

Beneficiary mentally incapacitated 0

Does not meet eligibility criteria 9

Spanish-language surveys AFMC translates all surveys into Spanish and provides the Spanish-language version to beneficiaries upon request (Appendix B). Of the 1,357 surveys returned, five were completed in Spanish.

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Demographics of Beneficiary Survey Sample and Population Table 4 compares the patient engagement survey population demographics with the survey sample and the survey sample with the analyzable sample. Any significant differences between the two groups (using a z-test for significant proportions) has been highlighted in the last two columns of the table. All significance testing is performed at the 95-percent significance level. Demographically, the survey sample was significantly different than the population in most categories. The sample for this survey used a minimum required sample size of 2,000 from four distinct populations that varied significantly in size. As seen on Table 4, the adult Medicaid population (ConnectCare) formed only 8.3 percent of the total population but a quarter of the sample. On the other hand, the child Medicaid population is 42.3 percent of the total population but constitutes only 24.9 percent of the sample. This should be kept in mind when interpreting the results for the table comparing the population with the sample demographics. Differences by age, although statistically significant, are not very substantial, with the largest difference of 3.6 percent noted in 18–24-year-olds and the smallest difference of 0.3 percent in those ages 55 and older among the adult beneficiaries. In the child population (ARKids First A and B), the largest difference is in those ages 13–18, with a significantly larger representation of this age group in the sample as compared with the population.

Table 4 also compares the surveyed beneficiaries’ (survey sample) demographics with the demographics of the survey respondents (analyzable sample). The respondents of the patient engagement survey were predominantly female. This is also in line with the general distribution of the survey sample, which is skewed towards females. The respondents were also mostly white (56.6%), with only 17.9 percent of respondents indicating they were African-American. An even smaller proportion of respondents identified as Asian or multiracial. This distribution also mirrors the race distribution of the patient engagement survey sample in general.

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Table 4: 2016 Beneficiary demographics – Comparison between population and samples

Demographics Survey

population (n = 588,003)

Survey sample

(n= 8,007)

Analyzable sample

(n= 1,354)

Statistical significance –

population vs. sample

Statistical significance –

sample vs. analyzable

sample

Age – ARKids First A and B

0 - 4 13.0% 10.1% 8.1% Yes Yes 5 - 8 12.6% 11.0% 9.7% Yes No 9 - 12 11.3% 13.4% 12.2% Yes No 13 - 18 12.2% 15.5% 15.2% Yes No

Age – Adult Medicaid and private option 18 - 24 8.7% 12.3% 8.1% Yes Yes 25 - 34 14.1% 12.9% 9.2% Yes Yes 35 - 44 10.8% 9.7% 9.4% Yes No 45 - 54 9.5% 7.9% 12.4% Yes Yes 55 or older 7.7% 7.4% 15.8% No Yes

Gender Male 46.2% 44.9% 45.3% Yes No Female 53.8% 55.1% 54.7% Yes No

Beneficiary Medicaid coverage ConnectCare (Adult Medicaid) 8.3% 25.0% 29.3% Yes Yes ARKids First A (Child Medicaid) 42.3% 24.9% 22.5% Yes No ARKids First B (CHIP) 6.7% 25.0% 22.7% Yes No HCIP (Private Option beneficiaries) 42.6% 25.1% 25.6% Yes No

Regions Northwest 29.8% 31.5% 31.8% Yes No Northeast 20.0% 19.1% 18.6% Yes No Central 27.9% 27.1% 25.6% No No Southwest 11.6% 11.7% 12.0% No No Southeast 10.7% 10.6% 12.0% No No

Race White 54.0% 55.7% 56.6% Yes No Black/African-American 23.1% 21.6% 17.9% Yes Yes Asian 0.8% 0.9% 1.3% No No Native Hawaiian or other Pacific Islander 0.2% 0.3% 0.1% No No

American Indian or Alaska Native 0.3% 0.5% 0.6% Yes No Other/Unknown 20.2% 19.5% 22.2% No Yes Multiracial 1.3% 1.5% 1.3% No No

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Patient Portal Access and Use by Beneficiaries Survey respondents can be divided into three groups depending on how they responded to questions 3 and 4 on the survey. The groups are:

Respondents whose provider either does not offer a patient portal or they are not aware of it (n= 879)

Respondents whose provider offers a patient portal but they have never tried to access it (n=262) Respondents whose provider offers a patient portal and they have accessed it (n=181)

The survey sample constituted adult and child beneficiaries from four different Medicaid populations. Table 5 displays the number and percentage of respondents by each group of Medicaid plan type and by access to/use of patient portal. Table 5: Patient portal access and use by type of Medicaid coverage

Access to/use of patient portal

ConnectCare (Adult Medicaid)

n= 386

ARKids First A (Child Medicaid)

n=298

ARKids First B (CHIP) n=302

HCIP (private option)

n=336 Range

Provider does not offer patient portal/ beneficiary does not know

68.9% 62.8% 68.2% 65.5% 6.1%

Provider offers patient portal but beneficiary has never tried to access it

18.1% 23.5% 17.9% 20.2% 5.6%

Provider offers patient portal and beneficiary has accessed it

13.0% 13.8% 13.9% 14.3% 1.3%

The majority of respondents from each plan type indicated that their provider did not offer patient portals or that they were unaware. The range is the difference between the highest and lowest proportions across rows. The highest range was noted in the group where “Provider does not offer patient portal/beneficiary does not know,” but this difference was not statistically significant. Of the 181 individuals who reported having access and using the portal, only 158 responded appropriately to the question that determined where they accessed it. Nineteen individuals responded with more than one selection although the question did not allow that. More than half indicated that they access the portal via a home computer or laptop, and more than a third access it via a personal mobile device (Table 6). Table 6: How the patient portal is accessed

Q6) How do you access the patient portal?

Q6 Frequency Percent

My home computer/laptop 81 51.3%

My personal mobile device 63 39.9%

Public computer such as at a library, church, senior center, etc. 12 7.6%

Other 2 1.3%

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Table 7: Access to and use of patient portal by demographics of survey respondents

Demographics Survey

respondents Have access to patient

portal through medical provider

(Total = 448)

Have access to and have used the patient portal (Total = 181) n %

Age

Under 18 100 7.4% 4.8% 1.1%

18–34 380 28.3% 29.6% 35.8%

35–54 568 42.3% 43.9% 45.8%

55 and older 295 22.0% 21.7% 17.3%

Gender

Male 358 26.7% 19.7% 14.5%

Female 981 73.3% 80.3% 85.5%

Education level

High school graduate or less 822 61.8% 53.2% 35.6%

Some college 397 29.8% 35.2% 47.2%

College graduate or more 111 8.3% 11.6% 17.2%

Race

White 884 67.8% 76.9% 83.0%

Black/African-American 277 21.2% 16.2% 11.9%

Asian 20 1.5% 0.5% 0.0%

Multiracial/Other 123 9.4% 6.5% 5.1%

Ethnicity

Yes, Hispanic or Latino 152 11.7% 7.3% 5.6%

No, Not Hispanic or Latino 1,148 88.3% 92.7% 94.4%

At the end of survey, there were questions about the demographics of the respondent. The respondents were mostly either the beneficiary themselves or the parent of a child beneficiary. Table 7 shows the percentages of respondents who indicated having access to and using the patient portal by demographic categories of age, gender, education level, race and ethnicity. Survey respondents within the “Under 18” age category constituted 7.4 percent of the total respondents, with only 4.8 percent of those having access to and only 1.1 percent of those using the patient portal. A similar pattern is seen in the “55 and older” age category. In contrast, while respondents ages 18–34 constituted 28.3 percent of the total survey respondents, that age group made up more than a third of the number of respondents that have used the portal (Table 7). Females are more likely to report using the patient portal. Only 73.3 percent of the total respondents were females compared with 85.5 percent in the group indicating that they use the portal. Similarly, whites and respondents who indicated their education level as “Some college” were most likely to report using a portal (Table 7).

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Reported Uses of the Patient Portal Respondents who indicated they use patient portals were asked about what they use it for and what they find to be the most valuable use of the patient portal. Table 8 and Table 9 display the results for those two questions. Utilization rates on Table 8 represent the percentage of respondents who selected that particular response option. As seen on the table, the options most commonly selected include “Office visit summaries” and “View lab test and results.” More than a third of the respondents selected “View health history including immunization records and medication lists” and “Update personal information” as uses of the portal. Table 8: Reported uses of the patient portal Q8) What do you use the patient portal for? Frequency Utilization Rate

Update personal information 68 38.4%

Office visit summaries 111 62.7%

View lab tests and results 111 62.7%

View health history including immunization records and medication lists 80 45.2%

Request appointments(s) 42 23.7%

Request referrals 19 10.7%

Request prescription refills 35 19.8%

Communicate with provider via email 36 20.3%

Make payments 17 9.6%

Ask billing questions 12 6.8%

Educational materials 16 9.0%

Other * 14 7.9% *Other responses include “Finding approved doctors,” “Just looking to see what on there,” “Review appointments and directions,” “See when appointments are coming up,” “To check PCP availability,” “To correct their intentional mistakes,” and “Was checking how it works.” Table 9: Most valuable use of the patient portal

Q9) From the choices you selected in Question 8, what do you find to be most valuable to you?


Updating personal information 10 8.8%

Office visit summaries 20 17.5%

View lab tests and results 44 38.6%

View health history including immunization records and medication lists 18 15.8%

Request appointment(s) 11 9.6%

Request referrals 1 0.9%

Communicate with provider via email 6 5.3%

Make payments 1 0.9%

Ask billing questions 3 2.6%

When survey respondents were asked to select what they find to be the most valuable use of the portals, 38.6 percent indicated viewing lab tests and results was the most valuable use, followed by 17.5 percent indicating that office visit summaries were the most valuable use. Less than five percent selected “Ask billing questions,” “Request referrals” and “Make payments” as the most valuable use of the portal.

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Frequency, Ease of Use and Satisfaction with Internet and Portals Table 10 shows the frequency, ease of use and satisfaction with patient portal use by Medicaid plan type. Table 11 shows the frequency of internet use, access to high-speed connections, and researching and discussing health care information with provider. The range for each row represents the difference between the highest and lowest proportion from each category responding positively to the question. Table 10: Frequency, ease of use and satisfaction with patient portal by Medicaid plan type

Portal Use ConnectCare

(Adult Medicaid) ARKids First A

(Child Medicaid) ARKids First

B (CHIP) HCIP (private

option) Range

n % n % n % n % Use the patient portal at least once a month or more (Q5) 49 46.9% 40 40.0% 41 26.8% 47 53.2% 26.4%

Find the patient portal extremely / very easy to use (Q7)

50 62.0% 41 58.5% 41 68.3% 48 68.8% 10.3%

Very satisfied / somewhat satisfied with using the patient portal (Q10)

48 77.1% 41 87.8% 39 89.7% 47 87.2% 12.6%

The largest range was noted for the question regarding frequency of portal use. More than half of the 47 private option respondents reported using the portal at least once a month or more, while only 26.8 percent of the ARKids First B parents reported using the portal as frequently. More than 75.0 percent of respondents representing beneficiaries from each group reported being “Very satisfied” or “Somewhat satisfied” with using the portal. Frequency, Ease of Use Internet use by Medicaid plan type

Table 11: Internet use by Medicaid plan type

Internet Use ConnectCare

(Adult Medicaid) ARKids First A

(Child Medicaid) ARKids First

B (CHIP) HCIP (private

option) Range n % n % n % n %

Have access to the internet all/most of the time (Q17) 385 53.5% 296 71.3% 302 81.5% 335 54.0% 28.0%

Beneficiaries with high-speed connection (Q18) 318 70.8% 279 79.2% 299 88.3% 289 70.9% 17.5%

Having an email address (Q20) 378 58.2% 298 76.5% 303 85.5% 335 67.5% 27.3% On average, "go online" at least once every week (Q21) 321 68.8% 286 83.9% 298 93.6% 296 71.6% 24.8%

Using internet for health care information for the patient (Q22)

379 19.0% 296 20.6% 303 23.8% 336 21.1% 4.8%

Discussing health care information from Internet with health care provider (Q25)

67 68.7% 59 72.9% 69 76.8% 65 66.2% 10.6%

For internet use by Medicaid plan type, a range of more than 20 percentage points was noted for having access to internet all or most of the time, having an email address and “going online” at least once every week. A larger proportion of the Child Medicaid and CHIP respondents has access to internet all/most of the time compared to the ConnectCare and private option adults. The respondents for the child plans

22

(ARKids First A and B) were also more likely to have email addresses and “go online” at least once every week. Reasons for dissatisfaction with using the patient portal

Survey respondents who indicated that they were “Somewhat dissatisfied” or “Dissatisfied” with using the portal were asked to indicate their reasons for the dissatisfaction. More than half the respondents felt the portal is not very user friendly, and 16.7 percent indicated they would need help or education on using it. Only two of the 24 who responded to this question indicated that they did not have a computer/internet of their own. Two of the 24 respondents were not interested in accessing their records electronically (Table 12). Table 12: Reasons for being dissatisfied with using the patient portal

Q11) Please indicate why you are not very satisfied with using the patient portal?


Not interested in accessing my records electronically 2 8.3%

The portal is not very user friendly 13 54.2%

I need help or education on using the patient portal 4 16.7%

I do not have Internet/computer of my own 2 8.3%

Other “After going on once it won’t let me back in.” “Couldn’t find what I needed.” “It is often incomplete and/or missing information; and I can’t print shot records from it.”

3 12.5%

23

Does Use of Patient Portals Correlate with Internet Access and Use? AFMC also explored the respondents’ access and use of portal by internet use and access question responses. The n in each column represents the total of individuals who responded to both questions, and the percentages indicate the proportion that answered positively. As seen on Table 13, 87.2 percent of respondents who use the portal have access to internet all/most of the time compared with 62.8 percent in the group that has access to the portal but does not use it. Similarly, of the 225 respondents who have access but do not use a portal, 76.4 percent have a high-speed connection, while a much higher proportion (91.5%) of the 177 respondents that use the portal reported they have high-speed internet connection. The largest difference in the groups using and not using the portal was noted for the “Using internet for health care information” question. Of 179 portal users, 69.3 percent also use the internet for health care information compared with only 13.5 percent in the non-users of the patient portal. Table 13: Patient portal access and use by Internet access and use

Access/use of internet

Provider does not offer patient

portal/ beneficiary does

not know

Provider offers patient portal but beneficiary has

not tried to access it

Provider offers patient portal and

beneficiary has accessed it

n % n % n % Have access to the internet all/most of the time (Q17) 860 60.5% 250 62.8% 180 87.2%

Beneficiaries with high-speed connection (Q18) 758 75.1% 225 76.4% 177 91.5%

Having an email address (Q20) 853 66.4% 253 71.9% 179 95.5% On an average, "go online" at least once every week (Q21) 772 76.4% 231 76.2% 175 96.6%

Using internet for health care information for the patient (Q22) 860 12.7% 251 13.5% 179 69.3%


104 70.2% 33 69.7% 115 72.2%

25

Beneficiaries Inclination and/or Barriers to Use Inclination towards using patient portal Individuals whose provider does not offer a patient portal were asked whether or not they would be inclined to use it if they could use it to access medical records, immunization records, check lab results, make appointments, request refills, make payments or even address medical concerns. As seen on Table 14, 518 out of 770 (67.3%) responded that they would be inclined to use it. The table also provides a breakdown of the responses by Medicaid coverage type. The least favorable response was from adult beneficiaries covered under the traditional Medicaid program with only 58.5 percent showing an inclination to use patient portals. Table 14: Inclination towards using patient portals by Medicaid plan type

Q14) If you were able to access medical records, immunization records, check lab results, make appointments, request refills, make payments, or address medical concerns, would

you be inclined to use the patient portal?

Response ConnectCare

(Adult Medicaid) n = 229

ARKids First A (Child Medicaid)

n = 169

ARKids First B (CHIP)

n = 177

HCIP (private option)

n = 195

Yes 58.5% 72.8% 74.6% 66.2%

Barriers to using patient portal Individuals whose provider offers a patient portal but they have never tried to access it were asked to indicate the reasons for not having used the patient portal from a list of possible reasons. Tables 15a and 15b lists the reasons as specified by these respondents. Table 15a: Barriers to using the patient portal Type of barrier Please indicate the reasons you have not used a patient portal? Frequency Utilization

Rate

- I am not aware that my provider offers a patient portal 21 8.7%

- Not interested in accessing my records electronically 76 31.4%

Access I do not have access to Internet/computer 62 25.6%

Physical Have physical disability that affects computer and Internet use 8 3.3%

Technological I am not comfortable using the computer or Internet 38 15.7%

Technological I think the web portal would be difficult to use 27 11.2%

Lack of awareness of benefits

My provider or his/her staff have never explained the benefits of using a patient portal

36 14.9%

- I am concerned about online privacy and security 55 22.7%

Language English is not my preferred language 4 1.7%

Health literacy I do not understand medical terms and abbreviations 29 12.0%

Other Other 43 17.8%

As seen on Table 15a, 31.4 percent of the 242 respondents are not interested in accessing their records electronically, 25.6 percent do not have access to internet or a computer, and 22.7 percent are concerned

26

about online privacy and security. Only 3.3 percent have a physical disability that affects computer use, and only four (1.7%) have language barriers. The respondents also had an option of listing a reason other than the ones specified. The “Other” responses are compiled below along with a count of the number of individuals who responded similarly. Table 15b: Barriers to using the patient portal – “Other responses” Reasons respondents have not used the patient portal – “Other responses” * Count

Can't remember where or how to use it & password 1

Don't have time to look online, but I like that its available if I needed it. 1

Have not got set up yet. 1

Have not had the need to access my records 2

Haven't thought about it. 1

Have not signed up for it. 3

Haven’t had a reason or need to use it. 6

I did not know what it was. There was sign at Dr. office say now have patient portal out.. 1

I do not have the time. 1

I have seizures and computers bring them on 1

I haven't had any questions or concerns up to now. I will use it when I need to. 1

I haven't had time then the code expires. 1

I haven't tried to access it yet 4

I receive a print out after my office visits of my medical history. 1

I speak English I don't no medical terms I don't understand portal 1

I ‘am handicap nonverbal. I ‘am the mom and filling out this paper would rather get information directly from doctor

1

I’ve never asked about it. 1

I’m elerate and can't read or write that well and it makes me very neverious to try anything new 1

Is not old enough 1

Just have not needed it and is usually hard to log into (time consuming) 1

Just haven't had the time nor the need to. 1

Medical provider has not provided the access code 1

My mother monitors my portal for me 1

My mother uses the portal for both of us. I’m 16 years old. 1

Never set up portal 1

No internet service no computer can't afford it. 1

No time 1

Not sick enough only need physical once a year 1

They cancelled my daughter ARKids for no reason an won’t get off their lazy butt to fix it when its DHS's fault.

1

When I need just call the doctor 1

Would need info in Spanish to be able to understand it. 1

* Responses listed are direct quotes and have not been edited in any way.

27

Demographic Analysis At the end of the patient engagement survey, there were questions about the demographics of the respondent. The respondents were mostly either the beneficiary themselves or the parent of a child beneficiary. The following tables show how the respondents in various demographic categories responded to the questions pertaining to internet use, ease and satisfaction of use with patient portal, and accessing and discussing health care information over the internet. The range is the difference between the highest and lowest value on the specific item. Caution should be exercised when making conclusions based on small numbers, and for a few tables, categories with fewer than 20 responses have been excluded from range calculations. Table 16: Internet and portal use and access by survey respondent age groups

Age groups Under 18 18–34 35–54 55 and older

Range n % n % n % n %

Have access to the internet all/most of the time (Q17) 98 67.3% 375 78.4% 555 63.6% 283 44.5% 33.9%

Beneficiaries with high-speed connection (Q18) 94 72.3% 363 84.3% 500 78.2% 222 65.3% 19.0%

Having an email address (Q20) 100 64.0% 375 84.3% 552 73.7% 280 50.4% 33.9%

On average, "go online" at least once every week (Q21) 97 78.4% 365 90.7% 511 79.3% 222 60.8% 29.9%


98 4.1% 375 26.7% 551 22.1% 283 16.3% 22.6%

Discussing health care information from Internet with health care provider (Q25)*

4 75.0% 97 73.2% 115 74.8% 40 60.0% 14.8%

Use the patient portal at least once a month or more (Q5)* 2 0.0% 63 39.7% 82 45.1% 28 42.9% 5.4%

Find the patient portal extremely/very easy to use (Q7)*

2 50.0% 64 70.3% 82 61.0% 30 60.0% 10.3%

Very satisfied/somewhat satisfied with using the patient portal (Q10)*

2 100.0% 63 85.7% 78 85.9% 30 80.0% 5.9%

* Categories with fewer than 20 responses were excluded from the range calculations. Many of the items registered pronounced differences of more than 20.0 percentage points among age groups. In general, compared with respondents in other age groups, the highest proportions of 18–34-year-olds have access to the internet all/most of the time, have high-speed connections, have an email address, go online at least once a week on average and use the internet to research health care information. This age group also registered the highest proportion that find the patient portal extremely/very easy to use. However, only 39.7 percent in this age category indicated that they use the patient portal at least once a month compared with 42.9 percent in the “55 and older” age group and 45.1 percent in the “35–54” age group.

28

Table 17: Internet and portal use and access by gender of survey respondent

Gender Male Female

Range n % n %

Have access to the internet all/most of the time (Q17) 346 50.9% 962 68.9% 18.0%

Beneficiaries with high-speed connection (Q18) 290 66.6% 887 80.7% 14.1%

Having an email address (Q20) 344 56.1% 961 76.5% 20.4% On average, "go online" at least once every week (Q21) 295 67.1% 899 83.2% 16.1%

Using internet for health care information for the patient (Q22) 345 10.4% 958 24.6% 14.2%

Discussing health care information from Internet with health care provider (Q25) 36 63.9% 220 73.2% 9.3%

Use the patient portal at least once a month or more (Q5) 25 60.0% 150 39.3% 20.7%

Find the patient portal extremely/very easy to use (Q7) 26 61.5% 152 64.5% 3.0%

Very satisfied/somewhat satisfied with using the patient portal (Q10) 26 84.6% 147 85.0% 0.4%

Large differences of more than 10 percentage points by gender were noted in internet and portal use and satisfaction. A larger proportion of females indicated having internet access all/most of the time, having high-speed connections, having an email address, going online at least once a week on average and using the internet to research health care information for the patient. When asked about the frequency of portal use, only 39.3 percent of females indicated that they use the portals at least once a month compared with 60.0 percent of male respondents. Table 18: Internet and portal use and access by education level of survey respondent

Education level of respondent High school

graduate or less Some college College

graduate or more Range

n % n % n % Have access to the internet all/most of the time (Q17) 797 55.7% 393 76.1% 111 82.9% 27.2%

Beneficiaries with high-speed connection (Q18) 689 69.5% 371 88.1% 107 90.7% 21.2%

Having an email address (Q20) 797 60.1% 390 87.4% 110 90.9% 30.8%

On average, "go online" at least once every week (Q21) 697 72.3% 379 88.4% 108 92.6% 20.3%

Using internet for health care information for the patient (Q22) 796 12.2% 389 33.2% 109 41.3% 29.1%


87 73.6% 124 70.2% 44 75.0% 4.8%

Use the patient portal at least once a month or more (Q5) 61 41.0% 85 49.4% 30 26.7% 22.7%

Find the patient portal extremely/very easy to use (Q7) 63 63.5% 85 65.9% 31 61.3% 4.6%

Very satisfied/somewhat satisfied with using the patient portal (Q10) 62 83.9% 82 89.0% 30 76.7% 12.3%

29

When comparing by survey respondents’ level of education, a higher proportion of respondents whose level of education is “College graduate or more” indicated having access to and using the internet more than the other groups. Again, similar to the age and gender categories, the pattern is reversed for patient portal use with a lower proportion of “College graduate or more” respondents using the patient portal at least once a month or more (26.7%) compared with 49.4 percent of respondents in the “Some college” category and 41.0 percent in the “High school graduate or less” category. Table 19: Internet and portal use and access by race of survey respondent

Race White Black/African-

American Other Range

n % n % n % Have access to the internet all/most of the time (Q17) 871 67.9% 272 52.6% 135 61.5% 15.3%

Beneficiaries with high-speed connection (Q18) 785 80.9% 229 67.7% 129 75.2% 13.2%

Having an email address (Q20) 870 76.4% 267 53.6% 138 72.5% 22.8% On average, "go online" at least once every week (Q21) 794 83.8% 234 62.4% 133 80.5% 21.4%

Using internet for health care information for the patient (Q22) 866 24.5% 268 14.6% 137 11.7% 12.8%

Discussing health care information from Internet with health care provider (Q25)*

200 73.0% 36 69.4% 15 66.7% 3.6%

Use the patient portal at least once a month or more (Q5)* 142 41.5% 21 57.1% 9 22.2% 15.6%

Find the patient portal extremely/very easy to use (Q7)* 145 60.0% 21 81.0% 9 88.9% 21.0%

Very satisfied/somewhat satisfied with using the patient portal (Q10)* 142 82.4% 20 100.0% 8 100.0% 17.6%

* Categories with fewer than 20 responses were excluded from the range calculations Among the race categories, whites in general had the highest proportion having high-speed connections and email addresses. They also reported more frequent access to the internet and more frequently accessing it. However, a higher proportion of black or African-American respondents use the patient portal at least once a month and also find it extremely/very easy to use. All of the 20 black or African-American respondents reported being very satisfied or somewhat satisfied with using the portals.

30

Table 20: Internet and portal use and access by beneficiary’s region of residence

Regions Northwest Northeast Central Southwest Southeast

Range n % n % n % n % n %

Have access to the internet all/most of the time (Q17)

416 67.1% 250 64.4% 334 65.6% 160 59.4% 158 57.0% 10.1%

Beneficiaries with high-speed connection (Q18) 380 79.2% 224 78.1% 300 79.0% 143 74.8% 138 68.8% 10.4%

Having an email address (Q20) 417 77.5% 245 71.4% 331 71.6% 161 68.3% 160 55.0% 22.5%

On average, "go online" at least once every week (Q21)

391 84.1% 225 79.6% 306 81.7% 143 73.4% 136 65.4% 18.7%


415 23.4% 248 18.5% 335 23.0% 161 19.9% 155 15.5% 7.9%


94 71.3% 39 74.4% 73 64.4% 30 80.0% 24 75.0% 15.6%

Use the patient portal at least once a month or more (Q5)*

72 43.1% 24 45.8% 49 38.8% 22 40.9% 10 50.0% 7.0%

Find the patient portal extremely/very easy to use (Q7)*

73 71.2% 24 54.2% 50 56.0% 23 73.9% 10 60.0% 19.7%

Very satisfied/somewhat satisfied with using the patient portal (Q10)*

73 90.4% 24 87.5% 49 77.6% 21 81.0% 8 87.5% 12.8%

* Categories with fewer than 20 responses were excluded from the range calculations The largest range by regions was noted for the “Having an email address” item. Only 55.0 percent of the respondents from the Southeast reported having an email address compared with more than two-thirds of respondents from all other regions. The least variation (range=7.0%) was seen on the item pertaining to patient portal frequency of use. Less variation was also noted on the “Using internet for health care information for the patient” item with a calculated range of only 7.9 percentage points. In general, there were more respondents from the Northwest region than any other.

31

Internet- and Health-Related Information Less than a quarter of all respondents (21.0%) use internet to research health care information for the beneficiary. Table 21 shows the type of health-related information that the respondents research on the internet. Table 21: Type of health related information researched on the internet

Q23) What type of health-related information do you research on the internet? Frequency Utilization

rate

Locate a medical provider 109 40.7%

Find a clinic, pharmacy or hospital 109 40.7%

Information about nutrition or diet 161 60.1%

Medication side-effects or complications 205 76.5%

Complications of medical therapy or procedure 80 29.9%

Information related to specific disease/condition such as diabetes or high blood pressure

167 62.3%

Information on complementary or alternative medicine 89 33.2%

Information concerning immunizations 67 25.0%

Other* 28 10.4% * Other responses are listed in the “Frequency Tables” section of this report. Of the 276 respondents who use the internet for health care information, 185 (67.0 percent) indicated that they discuss that information with the health care provider of the beneficiary. Figure 1 lists the websites that the survey respondents trust to get reliable health-related information and the utilization rates for each response. Since each respondent was allowed to select more than one response to this question, utilization rates relates reflect the proportion of respondents that selected each response option.

32

Figure 1: Websites trusted for reliable health related information

9.1%

11.4%

9.9%

66.7%

10.2%

11.4%

11.4%

11.4%

43.2%

31.8%

40.5%

60.2%

0% 20% 40% 60% 80%

Other

Site advertised on TV, radio, newspaper, magazine or Internet

Site recommended (TV, radio, newspaper, magazine or Internet)

Independent websites such as WebMD

Insurance company websites

Sponsored by a pharmaceutical company

Sponsored by a nonprofit organization

Sponsored by a medical insurer

Sponsored by a hospital

Sponsored by a university

Sponsored by a medical society

Site recommended by a physician or health care professional

When searching for medical information on the Internet, what websites do you trust to get reliable health-related information?

33

Beneficiary Survey – Frequency Tables

Q1) Are you the patient?

Q1 Frequency Percent Cumulative Frequency

Cumulative Percent

Yes 718 54.27 718 54.27

No 605 45.73 1323 100.00

Q2) Is the patient:


Cumulative Percent

Your child? 512 86.78 512 86.78

Your parent? 10 1.69 522 88.47

Other adult family member? 23 3.90 545 92.37

I am an employed caregiver 4 0.68 549 93.05

Other? 41 6.95 590 100.00

Q2) Other Responses Frequency Count

COUSIN 1

DHS CASEWORKER 1

DHS/DCFS CUSTODIANS 1

FOSTER CARE 1

FRIEND-CAREGIVER 1

GRAND CHILD 17

GRANDCHILD / LEGAL GUARDIAN 8

GRANDMOTHER 1

GRANDMOTHER/PERMANENT GUARDIAN 1

GREAT GRANDDAUGHTER 1

GUARDIAN / LEGAL GUARDIAN 2

MY FIRST COUSIN 1

NEIGHBOR 1

NEPHEW 1

NIECE 1

SISTER 1

34

Q3) Does the patient’s medical provider offer a patient portal?


Cumulative Percent

Yes 448 33.76 448 33.76

No 215 16.20 663 49.96

Don’t know 664 50.04 1327 100.00

Q4) Have you ever tried to access the patient portal over the Internet?


Cumulative Percent

Yes 181 40.86 181 40.86

No 262 59.14 443 100.00

Q5) How often do you use the portal?


Cumulative Percent

Three or more times a month 8 4.52 8 4.52

At least once a month 67 37.85 75 42.37

Once every six months 70 39.55 145 81.92

Once every 12 months 32 18.08 177 100.00

Q6) How do you access the patient portal?


Cumulative Percent

My home computer/laptop 81 51.27 81 51.27

My personal mobile device 63 39.87 144 91.14

Public computer such as at a library, church, senior center, etc. 12 7.59 156 98.73

Other 2 1.27 158 100.00


THE PUBLIC LIBRARY PUTS A SHORT TIME LIMIT ON USING PUBLIC COMPUTERS. SYSTEMS OUTDATED AND NOT SECURE.

1

WORK LAPTOP 1

Q7) How easy would you say it is to use the patient portal?


Cumulative Percent

Extremely easy 44 24.44 44 24.44

Very easy 72 40.00 116 64.44

Somewhat easy 52 28.89 168 93.33

Not at all easy 12 6.67 180 100.00

35

Q8) What do you use the patient portal for? Frequency Percent Utilization Rate

Update personal information 68 12.12 38.42

Office visit summaries 111 19.79 62.71

View lab tests and results 111 19.79 62.71

View health history including immunization records and medication lists

80 14.26 45.20

Request appointments(s) 42 7.49 23.73

Request referrals 19 3.39 10.73

Request prescription refills 35 6.24 19.77

Communicate with provider via email 36 6.42 20.34

Make payments 17 3.03 9.60

Ask billing questions 12 2.14 6.78

Educational materials 16 2.85 9.04

Other 14 2.50 7.91


FINDING APPROVED DOCTORS 1

HAVEN'T BEEN ABLE TO GET IN 1

I DON'T 1

I'VE ONLY BEEN ON 1 TIME & INFO WAS NOT IN THERE. 1

JUST LOOK TO SEE WHAT ON THERE 1

PLAN TO USE IT, SURE IT WILL SAVE ME GAS MONEY, TIME 1

REVIEW APPOINTMENTS AND DIRECTIONS 1

SEE WHEN APPOINTMENTS ARE COMING UP 1

TO CHECK PCP AVAILABILITY 1

TO CORRECT THEIR INTENTIONAL MISTAKES. 1

WAS CHECKING HOW IT WORKS. 1

Q9) From the choices you selected in Question 8, what do you find to be most valuable to you?


Cumulative Percent

Updating personal information 10 8.77 10 8.77

Office visit summaries 20 17.54 30 26.32

View lab tests and results 44 38.60 74 64.91

View health history including immunization records and medication lists

18 15.79 92 80.70

Request appointment(s) 11 9.65 103 90.35

Request referrals 1 0.88 104 91.23

Communicate with provider via email 6 5.26 110 96.49

Make payments 1 0.88 111 97.37

Ask billing questions 3 2.63 114 100.00

36

Q10) How satisfied are you with using the patient portal?


Cumulative Percent

Very Satisfied 84 48.00 84 48.00

Somewhat Satisfied 65 37.14 149 85.14

Somewhat Dissatisfied 18 10.29 167 95.43

Dissatisfied 8 4.57 175 100.00

Q11) Please indicate why you are not very satisfied with using the patient portal?


Cumulative Percent

Not interested in accessing my records electronically 2 8.33 2 8.33

The portal is not very user friendly 13 54.17 15 62.50

I need help or education on using the patient portal 4 16.67 19 79.17

I do not have Internet/computer of my own 2 8.33 21 87.50

Other 3 12.50 24 100.00

Q11) Other Responses Frequency

Count

AFTER GOING ON ONCE IT WON'T LET ME BACK IN. 1

COULDN'T FIND WHAT I NEEDED 1

IT IS OFTEN INCOMPLETE AND/OR MISSING INFORMATION; AND I CAN'T PRINT SHOT RECORDS FROM IT.

1

Q12) Has anybody other than yourself accessed the patient portal for the patient?


Cumulative Percent

Yes 19 10.67 19 10.67

No 159 89.33 178 100.00

Q13) Was the person who helped access the patient portal the patient’s:


Cumulative Percent

Spouse? 10 52.63 10 52.63

Other adult family member? 8 42.11 18 94.74

Caregiver? 1 5.26 19 100.00

37

Q14) If you were able to access your medical records and immunization records, check lab results, make appointments, request refills, make payments, or address medical concerns, would you be inclined to use a

patient portal?


Cumulative Percent

Yes 518 67.27 518 67.27

No 252 32.73 770 100.00

Q15) Please indicate the reasons you have not used a patient portal? Frequency Percent Utilization

Rate

I am not aware that my provider offers a patient portal 21 5.26 8.68

Not interested in accessing my records electronically 76 19.05 31.40

I do not have access to Internet/computer 62 15.54 25.62

I am not comfortable using the computer or Internet 38 9.52 15.70

Have physical disability that affects computer and Internet use 8 2.01 3.31

I think the web portal would be difficult to use 27 6.77 11.16

My provider or his/her staff have never explained the benefits of using a patient portal

36 9.02 14.88

I am concerned about online privacy and security 55 13.78 22.73

English is not my preferred language 4 1.00 1.65

I do not understand medical terms and abbreviations 29 7.27 11.98

Other 43 10.78 17.77

38


Count

CAN'T REMEMBER WHERE OR HOW TO USE IT & PASSWORD 1

DON'T HAVE TIME TO LOOK ONLINE, BUT I LIKE THAT ITS AVAILABLE IF I NEEDED IT. 1

HAVE NOT GOT SET UP YET. 1

HAVE NOT HAD THE NEED TO ACCESS MY RECORDS 2

HAVE NOT SIGNED UP FOR IT 3

HAVEN'T HAD A REASON TO USE IT YET. 1

HAVEN'T NEEDED TO ACCESS IT YET. 1

HAVEN'T THOUGHT ABOUT IT. 1

NO NEED TO DO SO YET 1

NO REASON TO ACCESS. 1

NO REASON TO ON THIS PATIENT AT THE TIME 1

NO REASON, HAVEN'T NEEDED TO. 1

I DID NOT KNOW WHAT IT WAS. THERE WAS SIGN AT DR. OFFICE SAY NOW HAVE PATIENT PORTAL OUT.

1

I DO NOT HAVE THE TIME. 1

I HAVE SIEZURES AND COMPUTERS BRING THEM ON 1

I HAVEN'T HAD ANY QUESTIONS OR CONCERNS UP TO NOW. I WILL USE IT WHEN I NEED TO. 1

I HAVEN'T HAD TIME THEN THE CODE EXPIRES. 1

I HAVEN'T TRIED TO ACCESS IT YET 4

I RECIEVE A PRINT OUT AFTER MY OFFICE VISITS OF MY MEDICAL HISTORY. 1

I SPEAK ENGLISH I DON'T NO MEDICAL TERMS I DON'T UNDERSTAND PORTAL 1

I'AM HANDICAP NON VERBAL. I'AM THE MOM AND FILLING OUT THIS PAPER WOULD RATHER GET INFORMATION DIRECTLY FROM DOCTOR

1

I'VE NEVER ASKED ABOUT IT. 1

IM ELERATE AND CAN'T READ OR WRITE THAT WELL AND IT MAKES ME VERY NEVERIOUS TO TRY ANYTHING NEW

1

IS NOT OLD ENOUGH 1

JUST HAVE NOT NEEDED IT AND IS USUALLY HARD TO LOG INTO (TIME CONSUMING) 1

JUST HAVEN'T HAD THE TIME NOR THE NEED TO. 1

MEDICAL PROVIDER HAS NOT PROVIDED THE ACCESS CODE 1

MY MOTHER MONITORS MY PORTAL FOR ME 1

MY MOTHER USES THE PORTAL FOR BOTH OF US. I'M 16 YEARS OLD. 1

NEVER SET UP PORTAL 1

NO INTERNET SERVICE NO COMPUTER CAN'T AFFORD IT. 1

NO TIME 1

NOT SICK ENOUGH ONLY NEED PHYSICAL ONCE A YEAR 1

THEY CANCELLED MY DAUGHTER ARKIDS FOR NO REASON AN WONT GET OFF THEIR LAZY BUTT TO FIX IT WHEN ITS DHS'S FAULT.

1

WHEN I NEED JUST CALL THE DOCTOR 1

WOULD NEED INFO IN SPANISH TO BE ABLE TO UNDERSTAND IT. 1

39

Q16) Do you own: Frequency Percent Utilization Rate

Cell phone without Internet? 318 14.32 23.82

Smartphone or cell phone with Internet? 870 39.17 65.17

Computer? 545 24.54 40.82

Tablet/iPad? 366 16.48 27.42

I do not own any of these 122 5.49 9.14

Q17) How often would you say you have access to the Internet?


Cumulative Percent

All of the time 558 42.34 558 42.34

Most of the time 286 21.70 844 64.04

Some of the time 232 17.60 1076 81.64

I do not have Internet access 242 18.36 1318 100.00

Q18) What type of Internet connection do you have?


Cumulative Percent

Dial-up (The computer dials a phone number, which is provided by your Internet service provider and connects to the network)

13 1.10 13 1.10

High-speed Internet connection (i.e. DSL, cable, satellite) 426 35.95 439 37.05

Other high-speed wireless connection (i.e. 4G, Wi-Fi, hotspot) 489 41.27 928 78.31

Not sure 257 21.69 1185 100.00

Q19) When you access the internet , is it via: Frequency Percent Utilization

Rate

Smartphone or cell phone with Internet? 863 46.08 72.52

Personal computer at home/work? 519 27.71 43.61

Public computer at a library, church, senior center, etc.?

143 7.63 12.02

Tablet/iPad? 270 14.42 22.69

Other? 78 4.16 6.55

40


A FRIEND SOMETIMES 1

ANYWAY I CAN AVOID GOVERNMENT. 1

AT FRIENDS HOUSE 1

BLURAY 1

BORROW LAPTOP 1

BORROWED COMPUTER FROM SCHOOL. 1

COLLEGE 1

DAUGHTERS 1

DO NOT 1

DON'T HAVE ACCESS TO INTERNET 6

DON'T HAVE COMPUTER 3

DON'T USE INTERNET 5

DSL WHEN I HAVE A COMPUTER 1

FRIEND'S HOUSE 1

FRIENDS COMPUTER AND INTERNET 1

FRIENDS SMARTPHONE 1

GIRLFRIEND'S COMPUTER 1

GOOGLE IT (ILLEGIBLE) GEMAIL 1

GRANDPARENTS HOUSE 1

I DO NOT ACCESS INTERNET, MY WIFE DOES. 1

I DO NOT NO HOW TO USE A PHONE OR COMP. 1

I DON'T OWN A COMPUTER OR HAVE THE INTERNET 1

I DON'T USE INTERNET NEVER LEARNED HOW 1

I HAVE NEVER USED A COMPUTER OF ANY KIND 1

IF 16-E IS CHECKED ALL QUESTIONS SHOULD STOP 1

MY FRIENDS 1

MY SISTERS HOUSE ON TABLET 1

MY WIFE HAS INTERNET I DO NOT 1

NONE OF THE ABOVE 3

NONE, MY CHILD * IS 1 YEARS OLD 1

NOT GOING TO ANSWER 1

ONLY FOR COST....FOR BEGGNER 1

PEOPLE WITH CELL PHONES 1

SCHOOL/SCHOOL COMPUTER 3

WIFI 1

WIFI HOT SPOTS 1

X-BOX 1

41

Q20) Do you have an email address?


Cumulative Percent

Yes 933 71.00 933 71.00

No 381 29.00 1314 100.00

Q21) On an average, how often do you go online?


Cumulative Percent

Many times daily 562 46.79 562 46.79

Once a day 197 16.40 759 63.20

Every few days 125 10.41 884 73.61

Once a week 68 5.66 952 79.27

Once a month 35 2.91 987 82.18

Rarely (less than once a month) 214 17.82 1201 100.00

Q22) Do you use the Internet for health care information for the patient?


Cumulative Percent

Yes 276 21.00 276 21.00

No 1038 79.00 1314 100.00

Q23) What type of health-related information do you research on the Internet? Frequency Percent Utilization

Rate

Locate a medical provider 109 10.74 40.67

Find a clinic, pharmacy or hospital 109 10.74 40.67

Information about nutrition or diet 161 15.86 60.07

Medication side-effects or complications 205 20.20 76.49

Complications of medical therapy or procedure 80 7.88 29.85

Information related to specific disease/condition such as diabetes or high blood pressure

167 16.45 62.31

Information on complementary or alternative medicine 89 8.77 33.21

Information concerning immunizations 67 6.60 25.00

Other 28 2.76 10.45

42


Count

ACCUPRESSURE 1

AUTISM, SEPARATION ANXIETY DISORDER. ADHD. SENSORY INTEGRAGATION 1

CHECK SYMPTOMS 1

CONDITIONS THAT HAVE SYMPTOMS CHILDREN/FAMILY MEMBER EXPERIENCES 1

DR. AND HEALTHCARE PROVIDERS RATING, WHAT OTHER PATIENTS HAVE TO SAY ABOUT THE CARE HOW EFECTIVE THE TREATMENT WAS. AND IF THAY WOULD REFER SOMEONE TO THEM.

1

DRUG USE AS A TEENAGER 1

HIS MEDICAL CONDITION 1

HOMEOPATHIC REMEDIES 1

I NEED THIS MEDICINE BAD I HAVE MEDICAID AND THEY WILL NOT PAY IT IS $200.00 I NEED IT SO BAD. IT IS AMRIX I NEED SOME INSURANCE THAT WILL PAY. I HAVE NO MONEY.

1

INFO FOR FREE BLUE CROSS AND BLUE SHILD COVERAGE 1

INFORMATION ABOUT HIS INJURY AND RESEARCH WHAT IS BEING DONE FOR CURE. 1

INFORMATION ABOUT MY DISEASE PRP 1

INFORMATION FOR AUTISM & SPEECH & LANGUAGE ACTIVITIES 1

INFORMATION ON VARIOUS HEALTH-RELATED ISSUES 1

INFORMATION ON WHAT MIGHT BE WRONG WITH THE PATIENTS 1

MENTAL HEALTH WHAT TO DO FOR.... 1

NATURAL MEDICINE 1

ORDER PRESCRIPTIONS 1

REFILL NEEDS 1

RENEWALL OF COVERAGE, LIKE WHEN AND HOW DO I DO THAT 1

SOCIAL MEDIA 1

SURAGE, OF KNEE REPLACEMENT FOR I NEED IT DUNE HAVE NOT MADE MIND UP ON THAT. 1

SYMPTOM CHECK 1

SYMTOMS OF ANXIETY, DEPRESSION, OCD AND VUSEL VEGEL SYCOPE SYNDROME. ETC... AND ALLERGIES

1

SYSTOMS, DEFINITIONS OF MEDICAL PROBLEMS 1

USE A SYMPTOM CHECKER-TYPE WEBSITE 1

Q24) When searching for medical information on the Internet, what websites do you trust to get reliable health-related information? Frequency Percent

Utilization Rate

Site recommended by a physician or health care professional 159 19.00 60.23

Sponsored by a medical society 107 12.78 40.53

Sponsored by a university 84 10.04 31.82

Sponsored by a hospital 114 13.62 43.18

Sponsored by a medical insurer 30 3.58 11.36

Sponsored by a nonprofit organization 30 3.58 11.36

Sponsored by a pharmaceutical company 30 3.58 11.36

Insurance company websites 27 3.23 10.23

43

Q24) When searching for medical information on the Internet, what websites do you trust to get reliable health-related information? Frequency Percent

Utilization Rate

Independent websites such as WebMD 176 21.03 66.67

Site recommended on the TV, radio, newspaper, magazine or Internet 26 3.11 9.85

Site advertised on TV, radio, newspaper, magazine or Internet 30 3.58 11.36

Other 24 2.87 9.09


Count

AVERAGE PEOPLE ON FORUM SOMETIMES 1

GOOGLE 5

GOOGLE AND ASK.COM 1

HEALTHLINE.COM 1

HERBAL 1

INFO ON PRIOR AUTHORIZATIONS AS NEEDED FOR HIS MEDICATIONS. 1

MAYO CLINIC 3

MY DAUGHTER HELPS ME. 1

NOTHING SPONSORED BY PHARMA! WHICH INCLUDES ALL OF THESE (A-G). NIH.GOV/CDC.GOV AND TOO MANY OTHERS TO LIST.

1

SITES FROM GOOGLE REFERED 1

SITES WRITTEN BY MOMS WHO HAVE REAL LIFE EXPERIENCE 1

WEBMD 3

WHAT COMES UP IN THE SEARCH 1

WHATEVER MIGHT HELP 1

WIKIPEDIA 1

WORLD WIDE WEB SEARCH 1

Q25) Do you discuss health care information learned from the Internet with the health care provider?


Cumulative Percent

Yes 185 71.15 185 71.15

No 75 28.85 260 100.00

44

Q26) What is your age?


Cumulative Percent

Under 18 100 7.45 100 7.45

18 to 24 108 8.04 208 15.49

25 to 34 272 20.25 480 35.74

35 to 44 301 22.41 781 58.15

45 to 54 267 19.88 1048 78.03

55 to 64 259 19.29 1307 97.32

65 to 74 30 2.23 1337 99.55

75 or older 6 0.45 1343 100.00

Q27) Are you male or female?


Cumulative Percent

Male 358 26.74 358 26.74

Female 981 73.26 1339 100.00

Q28) What is the highest grade or level of school that you have completed?


Cumulative Percent

8th grade or less 132 9.92 132 9.92

Some high school, but did not graduate 193 14.51 325 24.44

High school graduate or GED 497 37.37 822 61.80

Some college or 2-year degree 397 29.85 1219 91.65

4-year college graduate 63 4.74 1282 96.39

More than 4-year college degree 48 3.61 1330 100.00

Q29) Are you of Hispanic or Latino origin or descent?


Cumulative Percent

Yes, Hispanic or Latino 152 11.69 152 11.69

No, Not Hispanic or Latino 1148 88.31 1300 100.00

45

Q30) What is your race?


Cumulative Percent

White 884 67.79 884 67.79

Black or African-American 277 21.24 1161 89.03

Asian 20 1.53 1181 90.57

Native Hawaiian or other Pacific Islander 3 0.23 1184 90.80

American Indian or Alaska Native 7 0.54 1191 91.33

Other 81 6.21 1272 97.55

Multi-racial 32 2.45 1304 100.00

Q31) Did someone help you complete this survey?


Cumulative Percent

Yes 199 14.92 199 14.92

No 1135 85.08 1334 100.00

Q32) How did that person help you? Frequency Percent Utilization

Rate

Read the questions to me 91 33.09 45.73

Wrote down the answers I gave 58 21.09 29.15

Answered the questions for me 68 24.73 34.17

Translated the questions into my language 32 11.64 16.08

Helped in some other way 26 9.45 13.07

46

Additional comments

Access to patient portal

Have used the patient portal Age

Level of education Comments

No/Don't Know

NA 35 to 54

High School Graduate or Less

Q14) INTERNET CONNECTION IS A CONCERN DUE TO POOR CELL PHONE RECEPTION

No/Don't Know

NA 35 to 54

Some College

WHAT GOOD DID THIS DO ME - NONE - DON'T HAVE A DOCTOR NOR HAVE I NEEDED ONE HAD TO GET THIS CRAP BECAUSE OF YOUR DUMBASS PRESIDENT P.S. MEDICADE DOESN'T PROVIDE DENTAL CARE THEREFORE WHO NEEDS THIS SHIT

Yes Yes 55 and older


COULDN'T FIGURE IT OUT SO ITS USELESS FOR ME!; Q8) COMPUTER STUFF I DON'T KNOW HOW TO DO!; Q25) HAVEN'T BEEN ABLE TO ACCESS MY PATIENT PORTAL DON'T KNOW PASSWORD OR SOMETHING TO GET MY MESSAGES!

No/Don't Know

NA 55 and older


DO NOT USE INTERNET

No/Don't Know

NA 35 to 54


Q15) I DON'T UNDERSTAND MOST OF THIS I DON'T USE THE COMPUTER AT ALL I CALL PHONE ALL MY APT TO THE DOCTOR

No/Don't Know

NA 35 to 54


DO NOT HAVE INTERNET

No/Don't Know

NA 18 to 34

Some College

Q8) FIRST I'VE HEARD OF IT.

Yes No 35 to 54


Q19) I DON'T HAVE INTERNET, MY MOTHER DOES.

No/Don't Know

NA 35 to 54


INSIDE COVER) DO NOT SEND BACK TO ADDRESS MOVING. THANK YOU; Q25) DO NOT HAVE INTERNET

No/Don't Know

NA 18 to 34


I HATE SURVEYS STOP SENDING THEM TO ME! I HAVE A LIFE!!

Yes No 35 to 54


DON'T HAVE ANY THESE NO INTERNET OF ANY KIND

No/Don't Know

NA 35 to 54


I DON'T KNOW WHAT A PATIENT PORTAL IS

No/Don't Know

NA Under 18

Q15) COMPUTERS ARE A PEICE OF SHIT; Q19) DON'T GET ON INTERNET; Q28) NOT IN SCHOOL YET HIM 4 YEARS OLD

No/Don't Know

NA 35 to 54


Q19) TELEFONO CELLULAR CON INTERNET

Yes No Under 18


MY DAUGHTERS ARKIDS HAS BEEN ON HOLD SINCE 10/15 AND DHS SAYS THEY KNOW THEY SHOULDNT HAVE CANCELLED AND ARE WORKING ON IT.

47




No/Don't Know

NA 18 to 34


Q2) MY DAGHTER IS 7 YRS OLD. I TAKE HER TO THE DOCTOR WITH HER WITH HER ARKANSAS MEDICAID PROGRAM CARD THIS IS MY FIRST TIME HEARING ABOUT A PATIENT PORTAL.

-- 55 and older

Some College

Q5) WE DO NOT USE THE PORTAL;

Yes Yes 18 to 34


Q6) I WAS UNABLE TO GET ACCESS INTO THE PORTAL

Yes No Under 18


Q11) DON'T USE PORTAL

No/Don't Know

NA 18 to 34


Q13) NEVER USE INTERNET

No/Don't Know

NA 18 to 34

College Graduate or More

Q3) I DON'T KNOW WHAT DO YOU MEAN WITH "PORTAL" SINCE I HAVEN'T SEEN ANY PROMOTIONS. MAYBE I MISSED THEM FROM BROCHURES.

No/Don't Know

NA 35 to 54

Some College

FRONT COVER) NOTE: THE LETTER WITH THIS STATED YOU MAILED ONE BEFORE, I DIDN'T RECIEVE ONE.

No/Don't Know

NA 55 and older

Some College

DO NOT LIKE SOCIAL MEDIA OR INTERNET - SOCIAL MEDIA IS THE MOST UNSOCIAL THING INVENTED. I LIKE/PREFER TO WORK WITH A PERSON. NOTHING IS PERSONAL ANYMORE!Q19) RARELY - ONLY WHEN I HAVE TO.; Q21) FOR EMAILS AND FACEBOOK MESSENGER-

Yes No 35 to 54


HAVE NOT ACCESSED THE PATIENT'S PORTAL

Yes No 35 to 54


Q21) DNOT GET ON THE LINE

Yes No 55 and older


Q18) DON'T HAVE INTERNET CONNECTION!;

No/Don't Know

NA 55 and older


DO NOT USE COMPUTERS

Yes No 35 to 54


Q18) I HAVE A GOVERNMENT PHONE

No/Don't Know

NA 35 to 54


I DON'T HAVE A COMPUTER;

No/Don't Know

NA 18 to 34

Some College

Q25) MY DR. IS UNHELPFUL AND DOES NOT TALK TO ME ABOUT ANYTHING HE IS VERY RUDE. I'M BETTER OFF RELYING ON THE INTERNET FOR HELP AND USING THE ER FOR EMERGENCYS. WE NEED SOMEONE OTHER THAN * SO AT LEAST WE HAVE A CHOICE.

48




Yes No 35 to 54


I DON'T HAVE ANY OF THESE INTERNET; Q21) I DON'T GO ONLINE; Q23) I HAVE HIGH BLOOD HYPERTENSION HEART PROBLEM BONE DISORDER MY BREATHING; Q32) I TRY TO FILL IT OUT MYSELF THAT I KNOW HOW

No/Don't Know

NA 35 to 54


Q19) I DO NOT ACCESS THE INTERNET

Yes No 55 and older


Q19) DO NOT GET ON INTERNET;

No/Don't Know

NA 55 and older


Q7) DONT NO WHAT A PORTAL IS;

Yes Yes 18 to 34

Some College

PAGE 6) I RARELY USE PATIENT PORTAL BECAUSE THE SITE IS TOO COMPLICATED TO USE, AND OVERALL I HATE USING THE WEBSITE. TWO HOSPITALS I GO TO USE A SIMILAR SERVICE CALLED MYCHART, IT IS 200 TIMES BETTER THAN PATIENT PORTAL. IT IS SUPER EASY TO USE ON ANY DEVICE, MOBILE FRIENDLY, AND ALSO HAS AN APP. PATIENT PORTAL NEEDS TO TAKE LESSONS FROM MYCHART, OR BETTER YET DHS, AND OTHER HOSPITALS AND DOCTOR OFFICES STOP USING PATIENT PORTAL AND SWITCH TO MYCHART.

No/Don't Know

NA 35 to 54


I HAVE ABETTER OF ARKANSAS IT SUX AINT WORTH A SHIT I IWSH I HAD THE TRADITIONAL MEDICADE BACK THE STUFF I HAVE DOESN'T PAY SHIT

No/Don't Know

NA 35 to 54

Q5) WHAT IT MEAN THREE TIME FIVE TIME DAY; Q10) NONE UNDERSTANT; Q13) NO UNDERSTANT; Q16) I OWN BUT DON'T KNOW HOW TO USE; Q17) NO HOME INTERNET; Q19) MOST I LIKE I DON'T UNDERSTAND; Q20) I HAVE I NEED SEE NEVER USE; Q21) NO INTERNET HOME; Q24) NEVER DONT UNDERSTAND; Q25) NO READ; BACK OF SURVEY) I DON'T DO ANYTHING YOU SAY I JUST NEED TO CHECK MY BLOOD SUGAR MANY TIME A DAY. GET BACK NORMAL I NEED AND PAIN MEDICINE. I ASKING YOU DIABETES 300 IS GOOD OR NO GOOD.

No/Don't Know

NA 55 and older


OK MEDACAIDE IS NOT AS GOOD AS IT ONCE WAS. DON'T KNOW WHAT HAPPEN UNLESS IT BECAUSE OF OBAMA DON'T CARE. FOR I HAVE TO PAY A LOT OUT OF MY POCKET WERE I ONCE DID NOT.

No/Don't Know

NA 55 and older


Q14) DO NOT KNOW WHAT A PATIENT PORTAL IS

No/Don't Know

NA 55 and older

Some College

Q32) I ANSWERED QUESTIONS FOR MY DAUGHTER. SHE IS AN ADULT WITH LEARNING DISABILITY. SHE IS 36 A HIGH SCHOOL GRAD WITH SPECIAL ED.

Yes Yes 35 to 54

Some College

IT TOOK ME 4 MONTHS TO GET MEDICAID APPROVED USING THE ONLINE APPLICATION FOR MYSELF & MY SON.

49




Yes Yes 35 to 54

College Graduate or More

ENCLOSED LETTER: THE DOCTORS, ESPECIALLY THE PRIMARY CARE PHYSICIANS AND SOME ER PHYSICIANS-DO NOT CARE ABOUT ME AT ALL. IT'S A CONSTANT FIGHT BECAUSE OF PREJUDICE IN RESPECT TO ECONOMIC STATUS. STEREOTYPICAL OPINIONS OF DRUG ADDICTION WITHOUT PROOF OR CONTRARY TO MEDICAL EVIDENCE. REALLY, THEY DON'T CARE. I HAVE THE IMPRESSION THEY WANT ME TO SUFFER.Q10) JRMC IS GOOD AND UAMS. WOULD BE BETTER IF TESTS COULD BE PRINTED OFF. ALL TESTS.; Q16) NO NUMBER FOR GOVERNMENT BECAUSE OF MISUSE AND IDENTITY THEFT.; Q20) NOT FOR GOVERNMENT MISUSE. IDENTITY THEFT.; Q25) THEY RESENT ANY INFORMATION THAT COMES FROM THE INTERNET.

No/Don't Know

NA 55 and older


I DON'T UNDERSTAND WHAT PORTAL OR HALF OF THE OTHER QUESTIONS

No/Don't Know

NA 35 to 54

Some College

Q14) WHAT IS A PORTAL? COMPUTER;

Yes No Q1) DO NOT USE COMPUTER AT ALL;

No/Don't Know

NA 35 to 54


PEOPLE WITH DISBALATYS NEED MORE THAN 12 VISETS A YEAR FOR ALL DR.'S I HAVE 6 DR'S TO GO TO * HELP!! PLEASE!!

No/Don't Know

NA 55 and older


Q6) DO NOT ACCESS/DO NOT HAVE A COMPUTER OR ACCESS TO INTERNET; Q32) PATIENT CAN NO LONGER READ, WRITE, REASON OR COMPREHEND & HAS A VERY HARD TIME TALKING. (MOTHER) * THANK YOU!

Yes No 35 to 54


Q13) DO NOT ACCESS THE PORTAL

Yes No 35 to 54


Q16) DON'T KNOW HOW TO USE A COMPUTER;

Yes No 35 to 54


BUT DO ACCESS IT ON MYSELF

Yes Yes 18 to 34

Some College

NOT EASY TO USE ON MOBILE DEVICES. DOES NOT LOAD VERY WELL, SOMETIMES WILL NOT LOAD AT ALL

No/Don't Know

NA 55 and older


BOTTOM OF PAGE 4) TO WHOM IT MAY CONCERN I READ THE QUESTIONS FROM 18 TO 25 AND THEY JUST DON'T APPLY TO ME I HAVE NEVER USED A COMPUTER AND WITH MY SICKNESS THE LAST SEVENTEEN YEARS FROM ALL MY NUTRITION LOSS FROM MY GASTROPERESIS AND WEIGHTING AS LOW AS 68 POUNDS MY MENTALITY FROM HAVING SIEZERUS ALONG WITH AND CAUSE FROM MY NUTRITION LOSS I CANNOT REMEMBER OR ASSORB LEARNING OR DAY TO DAY NEEDS WITHOUT WRITING IT DOWN I KNOW I MISS OUT ON A LOT OF PEOPLE TELL ME BUT ITS JUST TO LATE FOR ME

51

Appendix A - Letters and postcard

Advance letter

Division of Medical Services

Dear Medicaid beneficiary: The Division of Medical Services has asked AFMC to conduct a survey. This survey will help DMS develop patient engagement strategies to increase the use of health IT and patient portals by our Medicaid population. This survey gives you the chance to tell us what you think about patient portals and using technology for your health care. In the next two weeks, you will be mailed a survey. Please tell us about your experience with patient portals. The survey will take you less than 20 minutes to complete. Because you are one of a few selected, it is very important that you fill out the survey and return it right away. Your responses will help us develop strategies to improve health care through technology. Once completed, please put your survey in the pre-paid envelope provided and return it to us by March 28. Your help is voluntary. Your benefits will not be affected in any way, whether or not you choose to participate. AFMC is an independent research firm that is helping us conduct the survey. No one but the staff at AFMC will see your answers. Your answers will not have your name on them and will be part of a pool of information from others like you. All information that identifies you will be STRICTLY CONFIDENTIAL. Thank you for helping to make health care better. If you have any questions, please call AFMC at 1-844-493-8763 (toll-free). Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. We are excited about this important project and need your support for it to succeed. Thank you in advance for your help. Sincerely,

Dawn Stehle Director

http://www.arkansas.gov/dhs

First survey letter


Dear Medicaid beneficiary: You may recall receiving a letter from us a couple of weeks ago. The Division of Medical Services has asked AFMC to conduct a survey. This survey gives you the chance to tell us what you think about patient portals and using technology for your health care. We are asking for your help. Please fill out the enclosed survey and return it by March 28 in the envelope provided. The postage has already been paid, so your participation will not cost you anything. It should take you about 20 minutes to complete the survey. All information you provide is completely confidential and will not have any effect on your Medicaid benefits. Your responses will be added to responses from other beneficiaries to form a picture of how beneficiaries use patient portals and other technology for their health care needs. Participation is voluntary and will not affect the services you receive. If you are unable to complete the survey by yourself, someone else can help you. Please call AFMC if you have questions about the survey or would like more information. Call 1-844-493-8763 (toll-free) anytime Monday through Friday between 8:30 a.m. and 5:00 p.m. Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. We hope you will decide to complete the survey because your experience is unique and cannot be replaced by anyone else. Sincerely,


54

Second survey letter


Dear Medicaid beneficiary: We need your help! Several weeks ago we mailed you a survey as part of an important study that we are conducting. If you have already returned the survey, thank you. If you have not completed the survey, please take some time today to do so. We need your answers to make this project a success. The Division of Medical Services is sponsoring the survey so we can learn what you think about the use of patient portals and the use of technology for your health care needs. This will help us serve you better. The responses you provide will go directly to AFMC and will be combined with the responses we get from others. No one at Medicaid will see your answers. All information that identifies you will be strictly confidential. Your help is voluntary and your benefits will not be affected in any way, whether or not you participate. In case you have misplaced the first survey we sent you, we have enclosed another copy. Please fill it out and return it by April 25 in the envelope provided. The postage has already been paid, so it will not cost you anything. It should take you about 20 minutes to complete the survey. If you feel this study does not apply to you, or if you have questions, please call AFMC at 1-844-493-8763 (toll-free). Si gusta recibir la versión en español de esta encuesta, favor llamar al 1-844-493-8763. We hope you will take this opportunity to tell us about your health care experiences. Your knowledge and experience could help us improve the quality of care that you receive. Thanks in advance for your help. Sincerely,


Postcard

57

Appendix B - Beneficiary Survey tools

58

English survey tool

68

Spanish survey tool

79

Provider Survey Results

81

Provider Survey Overview and Methodology Sampling frame

For the provider survey, a list of unique email IDs was generated from AFMC’s provider contact list in the CRM system. The online survey via SurveyMonkey was sent to 1,190 provider contacts for input regarding patient portals and using technology in their practice. The email addresses were for office staff and each individual was asked to complete the survey on behalf of a provider within their clinic, so that the responses would be based on the provider’s perspective. Survey procedure and timetable

On March 22, AFMC sent out an email to invite 1,190 provider contacts to take the survey via SurveyMonkey on behalf of providers whose name was listed on the accompanying email. The survey consisted of 17 questions. This was followed by the first reminder email a week later. A second reminder was sent to all contacts who had not responded a week later. The data collection was cut-off on April 12, a week after the second reminder was emailed out. Table 22: Survey timetable -Provider survey Survey mailings Date

Initial email invite March 22

First reminder email March 29

Second reminder email April 6

Data collection cutoff April 12

Survey tracking A unique number was assigned to each survey for tracking purposes only. This tracking number was used so that a second survey could be mailed to non-responders but not to those who had already completed and returned the survey. Provider confidentiality was never compromised.

83

Provider / Practice Characteristics and Portal Use Practices having no more than seven physicians make up 67.0 percent of respondents. Of the 215 practices that responded, 71.2 percent indicated the majority of care they provide is primary care. The distribution of community size in which the survey respondents practice is heterogeneous with almost equal representation from communities of different sizes. No more than 300 patients are seen per week by 69.3 percent of practices that responded. A small percentage of respondents, 14.0 percent, are not interested in MU (Table 23). Table 23: Provider practice scope and size

Practice characteristics 2016 Provider survey respondents (n = 215)

Practice size Frequency Percent

Solo 68 31.6%

Small group practice (2–7 physicians) 76 35.4%

Large group practice (8 or more physicians) 24 11.2%

Hospital affiliated group or practice 47 21.9%

Type of care provided

Primary care 153 71.2%

Medical subspecialty 28 13.0%

Surgical subspecialty 19 8.8%

Other* 15 7.0%

Size of community in which practice is located

5,000 or fewer 42 19.5%

5,001 to 10,000 29 13.5%

10,001 to 25,000 33 15.4%

25,001 to 50,000 35 16.3%

50,001 to 100,000 36 16.7%

100,001 or above 40 18.6%

Average number of patients seen each week

Fewer than 100 per week 54 25.1%

100–300 per week 95 44.2%

301–500 per week 34 15.8%

More than 500 per week 32 14.9%

Meaningful Use

Yes, I have achieved Meaningful Use 153 71.2%

No, but I am working on it 32 14.9%

No, not interested in Meaningful Use 30 14.0%

* Other responses included Chiropractic, ED, Interventional pain management, Physical therapy, Radiology, Vocational Rehab and General Medical Clinic, Wound and Hyperbaric, Otolaryngology, Psychiatry, OB/GYN, Urgent Care and Acute Family Medicine

84

Portal use by provider characteristics Among all the respondents, 74.0 percent (n=215) use a patient portal. Large group practices with eight or more physicians recorded the highest proportion of patient portal use (91.7%), while only 60.3 percent of solo practices reported using patient portals. Providers who selected primary care as the majority of services provided have the highest percentage of patient portal use (79.7%). Patient portal use does not seem to be affected by the size of the community in which the practice is located. Practices who see 100 patients or fewer per week are less likely to use a patient portal than practices who see more than 100 patients per week (Table 24). Of the 159 respondents using patient portals, 87.4 percent have achieved MU of EHR technology. Table 24. Practice characteristics and patient portal use

Practice characteristics Providers that use patient portals in their practice (n=215)

Practice size n Percent using patient portal

Solo 68 60.3%

Small group practice (2–7 physicians) 76 71.1%

Large group practice (8 or more physicians) 24 91.7%

Hospital affiliated group or practice 47 89.4%

Type of care provided

Primary care 153 79.7%

Medical subspecialty 28 71.4%

Surgical subspecialty 19 47.4%

Other 15 53.3%

Size of community in which practice is located

5,000 or fewer 42 71.4%

5,001 to 10,000 29 82.8%

10,001 to 25,000 33 63.6%

25,001 to 50,000 35 77.1%

50,001 to 100,000 36 75.0%

100,001 or above 40 75.0%

Average number of patients seen each week

Fewer than 100 per week 54 50.0%

100–300 per week 95 78.9%

301–500 per week 34 88.2%

More than 500 per week 32 84.4%

Meaningful Use

Yes, I have achieved Meaningful Use 153 90.8%

No, but I am working on it 32 53.1%

No, not interested in Meaningful Use 30 10.0%

85

Provider / Practice Experiences with the Portal When asked how their patient portal was supported, almost half of responders indicated they use an outside support vendor (Figure 2).

AFMC examined the provider/practice experiences with their patient portal and provided utilization data for questions where respondents were able to select more than one response. The utilization rate is the percentage of the total respondents who selected the particular option. A majority of practices responded that they use their patient portal for clinical summaries (73.9%), secure messaging (69.9%), requesting prescription refills/renewals (58.2%) and incorporating personal health records (58.2%) (Figure 3).

The respondents were also asked to indicate areas in which they think their patient portal has been useful. Although 64.1 percent of the respondents chose “Ease of sharing information with patients” and 45.8 percent

13%

14%

26%

47%

Figure 2: How is your patient portal supported? (n=153)

A hospital

A network affiliation

Internal support staff

Outside support vendor

4.6%

4.6%

13.7%

20.3%

23.5%

24.2%

24.8%

32.7%

37.9%

44.4%

47.1%

49.0%

58.2%

58.2%

69.9%

73.9%

0% 20% 40% 60% 80% 100%

Interoperability (interface multiple software systems)

Other (Please specify)

E-consultations and other patient communications

Health Information Exchange

Care plans

New patient registration/forms

Tracking patient engagement

Online bill pay

Sharing patient – specific education materials

Update demographic information

Appointment scheduling

Sending patient reminders for appointments,…

Incorporate personal health records including lab…

Request prescription refills and renewals

Secure messaging

Clinical summaries

Figure 3: Specify the purposes for which you use a patient portal? (n=153)

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of the respondents chose “Better patient-provider communication,” 20.3 percent of respondents selected “Other” as a response (Figure 4). Two of these responses include updating demographics and providing summaries of care. The “Other” category also contained several responses that could be classified as minimal or of no benefit.

The following utilization data shows respondents selected “Access to clinical summary (49.7%),” “Patient engagement (41.2%)” and “Transmission of patient information (34.6%)” as areas of measured improvement with the use of a patient portal (Figure 5). Included is a table containing all the comments from the “Other” category with some comments indicating little or no improvement due to low patient participation (Table 25).

11.1%

16.3%

20.3%

24.2%

27.5%

45.8%

64.1%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Tracking billing/payment information

Medication reconciliation


Setting appointment recalls and reminders

Ease of e-prescribing

Better patient-provider communication

Ease of sharing information with patients in atimely manner (test results, etc.)

Figure 4: What are the areas in which you think that patient portal has been useful/beneficial? (n=153)

7.2%

10.5%

17.6%

20.3%

20.3%

34.6%

41.2%

49.7%

0% 20% 40% 60% 80% 100%

Improved billing

Increased productivity

Scheduling appointments

E-prescribing convenience


Transmission of patient information

Patient engagement

Access to clinical summary

Figure 5: Would you say you have measured improvements from the use of a patient portal in the following areas: (n=153)

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Table 25: Other areas of measured improvements **

Would you say you have measured improvements from the use of a patient portal in the following areas:

Another employee that we had to add for salary to run the portal

Patients would rather use the phone

Patient participation is relatively low, so no.

I've not had a patient to use the portal

Our patients do not use this enough.

Will never meet MU due to patient portal

impossible to answer no to this question!!!

Very few people seem to use it

Not at this time

Not see a lot of change.

* Besides the comments listed above we also had nine providers who reported “No improvements/No measured improvement” , two reporting that it is “Rarely used” and two that are “Unsure/Not certain.”

**Comments are direct quotes and have not been edited in any way. Other general comments such as “none” or “Not helpful” etc. have been condensed and noted with an asterisk.

Forty-five percent of respondents (n=151) indicated their clinicians have remote access to the portal through mobile devices (Figure 6).

45%

55%

Figure 6: Do the clinicians have remote access to the portal through their mobile devices? (n=151)

Yes No

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Educating patients on use of patient portal When asked who recommends the use of the patient portal to their patients, 68.6 percent responded that clerical/front desk staff made the recommendation, 18.3 percent said a nurse or other provider, 11.8 percent said the physician provider and 1.3 percent said lab personnel or other clinic staff. The two methods used most in educating patients about the portal were verbal instructions (86.9%) and handouts/written instructions (71.9%) (Figure 7).

A large majority (83%) of 153 respondents to this question reported that they offer assistance in registering patients on the portal. The type of assistance offered varied, with 85.7 percent offering staff assistance and 65.1 percent offering a handout with instructions about how to sign on and use basic features (Figure 8).

5.2%

34.6%

71.9%

86.9%

0% 20% 40% 60% 80% 100%


Posters

Handouts/written instructions

Verbal instructions

Figure 7: How does the practice educate patients about their patient portal? (n=153)

1.6%

11.1%

46.0%

65.1%

85.7%

0% 20% 40% 60% 80% 100%


Registration kiosk

Explanation of benefits and advantages of use

Handout with instructions about how to sign onand use basic features

Staff assistance available

Figure 8: What type of assistance do you offer to register patients on the portal? (n=126)

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Obstacles for current users Respondents were able to select more than one choice from a list of provided obstacles they may have encountered when using a patient portal. The majority of providers selected options that indicate patient participation is an obstacle; 80.1 percent of providers indicated that their patients do not use technology, followed by 64.9 percent of providers saying their patients do not have access to technology (Figure 9).

Barriers for non-users to initiate the portal Among 56 respondents that do not use a patient portal in their practice, 96.4 percent indicated barriers to initiating the use of a patient portal. More than half (51.9%) said the expense for the practice (equipment) was a barrier. Almost 30 percent said the expense for the patient (computer/Internet) was a barrier to initiate the use of a patient portal. The same number of respondents (42.6% each) indicated time constraints and technical support would be barriers to initiate use of a patient portal (Figure 10). A table of comments for the “Other” response follows (Table 26).

10.6%

11.3%

12.6%

17.9%

21.2%

23.2%

33.8%

64.9%

80.1%

0% 20% 40% 60% 80% 100%

Lack of physician support


Expense for practice (equipment)

Redesigning practice workflow

Lack of technical support/training

Staff motivation

Time constraints

Patients do not have access to technology

Patients do not use technology

Figure 9: Obstacles when using a patient portal in my practice include: (n=151)

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Table 26. Other barriers to initiation of portal use ** Other barriers for my practice to initiate the use of a patient portal include:

I am very close to full retirement and cannot see that a whole lot of investment in computerized medical records and portals would be of benefit to me or the patients in our small rural area.

I work for the State and it is up to the State

In VA system

Portal does not add value or enhance patient care

Problems with portal with our emr vendor

Staff Size

Tested Patient Portal through eCW and it had so many flaws we had to discontinue

This is just fodder for the malpractice lawyers.

Working on getting an EHR with patient portal

retired

security concerns and responsibility

we are an RHC facility

**Comments are direct quotes and have not been edited in any way.

20.4%

22.2%

24.1%

24.1%

24.1%

29.6%

33.3%

42.6%

42.6%

51.9%

0% 20% 40% 60% 80% 100%

Migrating data

Lack of physician support

Staff education

Redesigning workflow

Other

Expense for patient (computer/Internet)

Patient education

Technical support

Time constraints

Expense for practice (equipment)

Figure 10: Barriers for my practice to initiate the use of a patient portal include: (n=54)

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Provider Survey - Frequency Tables

Q1: How would you describe your practice?


Cumulative Percent

Solo practice 68 31.63 68 31.63

Small group practice (2-7 physicians) 76 35.35 144 66.98

Large group practice (8 or more physicians) 24 11.16 168 78.14

Hospital affiliated group or practice 47 21.86 215 100.00

Q2: Would you say that the majority of care you provide is:


Cumulative Percent

Primary care 153 71.16 153 71.16

Medical subspecialty 28 13.02 181 84.19

Surgical specialty 19 8.84 200 93.02

Other (Please specify) 15 6.98 215 100.00

Q3: In what size community do you practice?


Cumulative Percent

5,000 or fewer 42 19.53 42 19.53

5,001 to 10,000 29 13.49 71 33.02

10,001 to 25,000 33 15.35 104 48.37

25,001 to 50,000 35 16.28 139 64.65

50,001 to 100,000 36 16.74 175 81.40

100,001 or above 40 18.60 215 100.00

Q4: On an average, how many patients does your practice see each week?


Cumulative Percent

Fewer than 100 per week 54 25.12 54 25.12

100 – 300 per week 95 44.19 149 69.30

301 – 500 per week 34 15.81 183 85.12

More than 500 per week 32 14.88 215 100.00

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Q5: Are you a Meaningful User of certified EHR technology?


Cumulative Percent

Yes, I have achieved MU 153 71.16 153 71.16

No, but I am working on it 32 14.88 185 86.05

No, I am not interested in Meaningful Use 30 13.95 215 100.00

Q6: Do you use a patient portal in your practice?


Cumulative Percent

Yes 159 73.95 159 73.95

No 56 26.05 215 100.00

Q7:How is your patient portal supported?


Cumulative Percent

A hospital 20 13.07 20 13.07

A network affiliation 22 14.38 42 27.45

Internal support staff 39 25.49 81 52.94

Outside support vendor 72 47.06 153 100.00

Q8: Specify the purposes for which you use a patient portal. Frequency Percent Utilization Rate

Appointment scheduling 72 8.02 47.06 Clinical Summaries 113 12.58 73.86 Tracking patient engagement 38 4.23 24.84 Care plans 36 4.01 23.53 Incorporate personal health records including lab and test results, immunization records, etc. 89 9.91 58.17

New patient registration forms 37 4.12 24.18 Sending patient reminders for appointments, screenings, immunizations, etc. 75 8.35 49.02

Request prescription refills and renewals 89 9.91 58.17 Online bill pay 50 5.57 32.68 Secure messaging 107 11.92 69.93 E-consultations and other patient communications 21 2.34 13.73 Health Information Exchange 31 3.45 20.26 Interoperability (interface multiple software systems) 7 0.78 4.58 Sharing patient - specific education materials 58 6.46 37.91 Update demographic information 68 7.57 44.44 Other 7 0.78 4.58

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Q9: What are the areas in which you think that patient portal has been useful/beneficial? Frequency Percent Utilization Rate

Better patient-provider communication 70 21.88 45.75 Ease of sharing information with patients in a timely manner (test results, etc.) 98 30.63 64.05

Ease of e-prescribing 42 13.13 27.45 Medication reconciliation 25 7.81 16.34 Tracking billing/payment information 17 5.31 11.11 Setting appointment recalls and reminders 37 11.56 24.18 Other 31 9.69 20.26

Q10: Would you say you have measured improvements from the use of a patient portal in the following areas: Frequency Percent Utilization

Rate Scheduling appointments 27 8.77 17.65 E-prescribing convenience 31 10.06 20.26 Transmission of patient information 53 17.21 34.64 Access to clinical summary 76 24.68 49.67 Improved billing 11 3.57 7.19 Increased productivity 16 5.19 10.46 Patient engagement 63 20.45 41.18 Other 31 10.06 20.26

Q11:Who recommends the use of the patient portal to your patients?


Cumulative Percent

Clerical/front desk staff 105 68.63 105 68.63

Lab personnel or other clinic staff 2 1.31 107 69.93

Nurse or other provider 28 18.30 135 88.24

Physician provider 18 11.76 153 100.00

Q12: How does the practice educate patients about

their patient portal? Frequency Percent Utilization Rate

Posters 53 17.43 34.64 Handouts/written instructions 110 36.18 71.90 Verbal instructions 133 43.75 86.93 Other 8 2.63 5.23

Q13:Do you offer assistance in registering patients on the portal?


Cumulative Percent

Yes 127 83.01 127 83.01

No 26 16.99 153 100.00

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Q14: What type of assistance do you offer to register

patients on the portal? Frequency Percent Utilization Rate

Registration kiosk 14 5.30 11.11 Staff Assistance available 108 40.91 85.71 Handout with instructions about how to sign on and use basic features 82 31.06 65.08

Explanation of benefits and advantages of use 58 21.97 46.03 Other 2 0.76 1.59

Q15: Do the clinicians have remote access to the portal through their Mobile devices?


Cumulative Percent

Yes 68 45.03 68 45.03

No 83 54.97 151 100.00

Q16: Obstacles when using a patient portal in my

practice include: Frequency Percent Utilization Rate

Lack of physician support 16 3.85 10.60 Expense for practice (equipment) 19 4.57 12.58 Lack of technical support/training 32 7.69 21.19 Staff motivation 35 8.41 23.18 Redesigning practice workflow 27 6.49 17.88 Time constraints 51 12.26 33.77 Patients do not have access to technology 98 23.56 64.90 Patients do not use technology 121 29.09 80.13 Other 17 4.09 11.26

Q17: Barriers for my practice to initiate the use of a patient

portal include: Frequency Percent Utilization Rate

Lack of physician support 12 7.06 22.22 Expense for practice (equipment) 28 16.47 51.85 Technical support 23 13.53 42.59 Migrating data 11 6.47 20.37 Staff education 13 7.65 24.07 Redesigning workflow 13 7.65 24.07 Time constraints 23 13.53 42.59 Patient education 18 10.59 33.33 Expense for patient (computer/internet) 16 9.41 29.63 Other 13 7.65 24.07

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Appendix C - Provider Survey Tool

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The Division of Medical Services has asked AFMC to conduct this survey. This survey will help DMS, under the direction of a practicing physician, develop provider engagement strategies to increase the use of health IT and patient portals by providers. This survey gives you the chance to tell us what you think about patient portals and using technology for your practice. Your feedback is important!

1. How would you describe your practice? o Solo practice o Small group practice (2-7 physicians) o Large group practice (8 or more physicians) o Hospital affiliated group or practice

2. Would you say that the majority of care you provide is:

o Primary care o Medical subspecialty o Surgical specialty o Other (Please specify) ___________

3. In what size community do you practice?

o 5,000 or fewer o 5,001 to 10,000 o 10,001 to 25,000 o 25,001 to 50,000 o 50,001 to 100,000 o 100,001 or above

4. On an average, how many patients does your practice see each week?

o Fewer than 100 per week o 100 – 300 per week o 301 – 500 per week o More than 500 per week

5. Are you a “Meaningful User” (MU) of certified electronic health record technology?

o Yes, I have achieved MU o No, but I am working on it o No, I am not interested in Meaningful Use

A patient portal is a secure online website that gives you convenient 24-hour access to your personal health information and medical records from anywhere with an Internet connection.

6. Do you use a patient portal in your practice? o Yes o No - Skip to question 17

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7. How is your patient portal supported? o A hospital o A network affiliation o Internal support staff o Outside support vendor

8. Specify the purposes for which you use a patient portal? (Select all that apply.)

o Appointment scheduling o Clinical summaries o Tracking patient engagement o Care plans o Incorporate personal health records including lab and test results, immunization

records, etc. o New patient registration/forms o Sending patient reminders for appointments, screenings, immunizations, etc. o Request prescription refills and renewals o Online bill pay o Secure messaging o E-consultations and other patient communications o Health Information Exchange o Interoperability (interface multiple software systems) o Sharing patient – specific education materials o Update demographic information o Other (Please specify.) ____________________________________

9. What are the areas in which you think that patient portal has been useful/beneficial? (Select

all that apply.) o Better patient-provider communication o Ease of sharing information with patients in a timely manner (test results, etc.) o Ease of e-prescribing o Medication reconciliation o Tracking billing/payment information o Setting appointment recalls and reminders o Other (Please specify.) ______________________________________

10. Would you say you have measured improvements from the use of a patient portal in the

following areas: (Select all that apply). o Scheduling appointments o E-prescribing convenience o Transmission of patient information o Access to clinical summary o Improved billing o Increased productivity o Patient engagement o Other (Please specify.) ______________________________________

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11. Who recommends the use of the patient portal to your patients? o Physician provider o Nurse or other provider o Clerical/front desk staff o Lab personnel or other clinic staff

12. How does the practice educate patients about their patient portal (Select all that apply)?

o Posters o Handouts/written instructions o Verbal instructions o Other (Please Specify.) ____________________________________

13. Do you offer assistance in registering patients on the portal?

o Yes o No - Skip to question 15

14. What type of assistance do you offer to register patients on the portal? (Select all that

apply.) o Registration kiosk o Staff assistance available o Handout with instructions about how to sign on and use basic features o Explanation of benefits and advantages of use o Other (Please Specify.) _____________________________________________

15. Do the clinicians have remote access to the portal through their mobile devices?

o Yes o No

16. Obstacles when using a patient portal in my practice include: (Select all that apply.)

o Lack of physician support o Expense for practice (equipment) o Lack of technical support/training o Staff motivation o Redesigning practice workflow o Time constraints o Patients do not have access to technology o Patients do not use technology o Other (Please Specify.) _____________________________________________

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17. Barriers for my practice to initiate the use of a patient portal include (Select all that apply.)

o Lack of physician support o Expense for practice (equipment) o Technical support o Migrating data o Staff education o Redesigning workflow o Time constraints o Patient education o Expense for patient (computer/internet) o Other (Please Specify.) _____________________________________________

Thank you for your participation!

THIS MATERIAL WAS PREPARED BY THE ARKANSAS FOUNDATION FOR MEDICAL CARE INC. (AFMC) UNDER CONTRACT WITH THE ARKANSAS DEPARTMENT OF HUMAN SERVICES, DIVISION OF MEDICAL SERVICES.THE CONTENTS PRESENTED DO NOT NECESSARILY REFLECT ARKANSAS DHS POLICY. THE ARKANSAS DEPARTMENT OF HUMAN SERVICES IS IN COMPLIANCE WITH TITLES VI AND VII OF THE CIVIL RIGHTS ACT. MP2-PATIENTENGAGE.EXEC.RPT,2-6/16

2016 patient engagement satisfaction survey results · surveymonkey on behalf of providers whose...

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