PROPOSAL TITLE: Improving Health and Tech Literacy by Optimizing MyChart usage through a Student Patient Navigator Program
PROJECT LEADS:
Helen Lau RN CPNP – Craniofacial Pediatric Nurse Practitioner
Jaclyn Kukoff SLP – Speech Pathologist
EXECUTIVE SPONSORS: Jason Selinger, MBA – Vice President, Ambulatory Services, UCSF Benioff Children’s Hospitals
ABSTRACT MyChart is a healthcare application that can be a critical part of a patient or family’s experience at UCSF, with the potential to make their healthcare more organized, accessible, and engaging. It provides an easy way to view medical records, upcoming appointments, and communicate with providers.We are committed to expanding access and usage of MyChart, by providing personalized and culturally appropriate training to patients and families in the waiting room. We plan to do this by partnering with the Volunteering Office to identify student volunteers who have already been onboarded to UCSF Benioff Children’s Hospitals. We plan to train student volunteers to encourage downloading and use of the MyChart App, showing families how to add their child as a proxy, demonstrating how to locate appointments, messaging providers, and uploading insurance information with a demonstration.
PROBLEM
Background and Equity Gaps
- Underutilization of health application: Currently, usage of MyChart for Craniofacial patients is underutilized. Of our patients with craniofacial differences seen in the last 5 years, 67% have signed up for MyChart, and 10% have logged on. For those identifying as English speaking, 71% downloaded MyChart and only 10% logged in. For our Spanish speaking families, 59% downloaded the app and only 9% logged in. For our Arabic speaking families, 61% signed up for the app but only 8% logged in. Information on additional language utilization is available upon request.
- Multidisciplinary care: For our patients with craniofacial differences, multiple specialties are often involved in their care including speech, neurosurgery, social work, nursing, plastic, ophthalmology etc. among other specialists. MyChart can be an organizational tool to track appointments, communicate with the care team and can increase access to medical care through efficient care coordination.
- Operational and financial metrics include MyChart enrollment, MyChart usage, no show rates, and visit volumes.
- This is a particularly salient problem in our ever-changingtechnological world. We plan to leverage technology to help improve patient autonomy and care. We also serve a diverse population and would like to decrease disparities in health and tech literacy.
TARGET
MEASURABLE PROGRAMMATIC GOALS
- Student volunteers will increase MyChart enrollment in the craniofacial department by 5 %after 3 months
- Student volunteers will increase MyChart usagein in the craniofacial department by 5 % after 3 months
- Student volunteers will increase family/patient self-reported comfort in using MyChart by 10 % measured by pre and post intervention surveys after 3 months
Our visits in the Craniofacial Center can last anywhere from 15 min for a post op appointment to 60 min for a new patient with complex needs. Frequently, there is not enough time to review how to download or use MyChart during the visit or the parents are in a rush to leave the hospital/clinic.
Although there is a handout that details how to download MyChart which may be given to the family at the registration desk, parents continue to have difficulty following the instructions on how to get started with MyChart especially with parent identification as a proxy. Within our center, we do try to review how to download the app as much as we can however, the decreased number of families who log in compared to downloading the app show that parents are not effectively utilizing MyChart.
INTERVENTION
Practice setting and target population: Outpatient Craniofacial department, Medical subspecialities 5th floor, waiting room. We see patients with congenital and acquired craniofacial differences. This includes facial trauma, cleft palate, and craniosynostosis.
- On any given day, 1-2 providers see between 8-16 patients over a period of 3-5 hours. We have anywhere from 1 room to 3 exam rooms during this time.
- The ability to be roomed on time may be dependent not only on room availability but also staffing
- While in the waiting room, we are proposing that Student Volunteers can offer a brief training to familiarize families on MyChart usage
- Staff: Partner with high school and college student volunteers (already onboarded, completed Immunizations, background check, training and HIPAA) and offer a stipend per quarter of work. Preferably bilingual/bicultural volunteers
- Timing: ~10 minutes
- Process
- Short survey: Families will fill out a short survey asking the initial reason they downloaded the app (if applicable) and what the biggest barrier is to logging in.
- MyChart Training: Volunteers review how to use MyChart in the waiting room. We anticipate this tutorial to take less than 10 minutes.
- Incentive: Families will receive a coupon for food or drink from the cafe after they complete the surveys and training.
- Follow up: If the families have further questions, they can see the volunteer after completion of their appt. We will also have additional MyChart handouts available so that if parents have questions after they leave their appointment.
- Data: We will measure gaps using pre and post intervention MyChart use data. We may also consider a survey pre and post intervention measuring family’s confidence in using the application.
- Potential Barriers
- Because it is a shared waiting room with other subspecialties, we may encounter patients who are present to see other medical subspecialties and not just craniofacial.
- Possible adverse outcomes
- Traffic in clinic space
- Germ precautions
- Possibility that families use MyChart incorrectly
PROPOSED EHR MODIFICATIONS N/A
RETURN ON INVESTMENT (ROI)
SUSTAINABILITY
This intervention will remain sustainable past the funding year as this work can be accomplished through the volunteer department to recruit new student navigators. We also believe that once we equip families with the knowledge on how to navigate MyChart, they will continue to use it independently.
BUDGET
