Check-In Check-Up: Analyzing and Improving Pre-Appointment Engagement in a in a Primary Care Clinic at UVA Health System; Burden to Balance: Reducing Healthcare Fatigue with Patient-Centered Digital (STS Research Paper)

In my technical project and STS research paper, I explored how improving patient engagement with digital health technologies can help alleviate the current workload on nurses and physicians. While my technical project focused on implementing strategies to increase MyChart enagement among patients at UVA Health, my STS research paper examined the broader systemic issue of clinical staff burnout and how MyChart, when utilized by most patients, can mitigate operational strains. Both projects relate to one another since the solution from my technical project could aid in solving the issue relating to clinical staff burnout. This interdisciplinary approach combines technical interventions with sociotechnical analysis to address healthcare challenges from multiple perspectives. My technical project evaluated two solutions at the University Physicians Clinic (UPC) designed to enhance patient usage of the MyChart portal. The first strategy involved personalized batched messaging from providers to encourage patients to complete eCheck-In and Health Risk Assessments before appointments. The second strategy introduced a student volunteer support program, where trained student volunteers assisted patients with portal usage directly in clinic waiting areas. Results showed that personalized provider messaging led to a 19% increase in Annual Wellness Visit (AWV) Questionnaire completion rates, while patient surveys revealed that in-person support helped overcome usability barriers like login confusion and app unfamiliarity. Together, these efforts demonstrated that increasing patients’ digital engagement can reduce redundant clinical tasks, improve operational efficiencies, and support staff workload reduction. By prioritizing human-centered design, the interventions acknowledged that successful technological adoption depends not only on functionality, but also on user behaviors, preferences, and trust. In my thesis, I argued that patient portal technology alone is insufficient to relieve clinical burdens without deliberate integration of user support, education, and usability improvements. Using a sociotechnical systems framework, I analyzed barriers such as digital literacy gaps, login difficulties, and lack of patient confidence in using healthcare technology. I referenced previous studies relating to patient portals such as the MyChart Genius Project and studies on EMR burden to show that healthcare institutions must not only deploy patient portals, but also design systems that actively reduce friction for both patients and providers. This was then paired with current data from the UPC electronic medical record systems and patient surveys. Ethical considerations were also central to my analysis. As healthcare systems become increasingly digital, institutions must ensure that patient portals are accessible and equitable, preventing disparities that could worsen digital literarcy. Technology must empower all patients, regardless of their technical comfort levels, to avoid exacerbating healthcare inequities and to promote patient autonomy, fairness, and trust in digital care environments. Moreover, both projects highlighted the importance of adaptability and resilience in healthcare system design. Patient needs, clinical workflows, and technological landscapes are continuously evolving. Effective digital health solutions must anticipate change and incorporate flexibility, whether through continuous patient education initiatives, iterative app improvements, or integrated feedback mechanisms. Sustainable improvements in healthcare delivery require systems that can respond dynamically to disruptions, demographic shifts, and new barriers to adoption. My project findings suggest that fostering resilience at both the patient and system level is essential for maintaining long-term operational gains from digital engagement strategies. Working on my thesis highlighted for me how technical interventions and systemic human factors are deeply interdependent. Testing engagement strategies showed that technical fixes without social support are limited in effect, while sociotechnical research provided a broader lens for understanding why many promising technologies fail to achieve meaningful outcomes. Moving forward, I will approach future research with a holistic mindset, prioritizing ethical responsibility, adaptive system design, and patient-centered strategies that strengthen both technological performance and social impact.