Improving access and communication of rural cancer patients through enhanced usage of patient portal.

e13817 Background: Oncology patients living in medically underserved areas face an increased risk of care gaps due to decreased utilization of the patient portal “CareSpace”, our EMR's two-way communication tool. These gaps can result in missed opportunities for communication with providers, missed appointments, and limited access to medical records. Many patients decline portal invitations, often failing to recognize its benefits. To address this, we aimed to quantify the number of patients in "declined status" and implement quality improvement interventions at multiple stages to enhance these outcomes. Methods: A review of portal usage data revealed that 45% of patients in our southern region were classified as being in "declined status." Two Plan-Do-Study-Act (PDSA) cycles were conducted to identify and address the causes of low CareSpace utilization. PDSA Cycle 1: Analysis revealed that the system automatically assigned patients to "declined status" if their email address was omitted, discouraging staff from inviting them to the portal. To address this, we removed the automation process. PDSA Cycle 2: We implemented a new workflow to collect email addresses at the referral stage and automatically send portal invitations through our Central Referral Office team. Results: The removal of the automated declining process during PDSA Cycle 1 resulted in an immediate reduction in the percentage of patients in "declined status" from 45% to 36%. Subsequently, the introduction of email collection at the referral stage in PDSA Cycle 2 reduced this percentage further, from 36% to 32%, enabling us to surpass our initial goal. Conclusions: These interventions significantly improved patient portal enrollment in underserved areas. The removal of the automated decline process and the early collection of email addresses contributed to achieving a reduction in "declined status" from 45% to 32%. This success has inspired other departments to undertake performance improvement projects focused on enhancing patient education and portal utilization. Barriers and Next Step: Portal invitations are valid for only 48 hours. To address this, we are working with our business intelligence team to develop a bot that will resend portal invitations periodically. This enhancement aims to further reduce barriers to portal adoption and improve access to care.