Presentation Authors: Naveen Kachroo*, Sriharan Sivalingam, Cleveland, OH
Introduction: Electronic patient portals (MyChart), allow for direct physician engagement at times of need. This resource can mutually benefit both patient and provider, especially during the peri-operative period by minimizing unnecessary provider visits, eliminating inconvenient and often circuitous telephone encounters and prevent avoidable emergency room (ER) visits. We sought to determine patterns of patient portal use among our endourology patients and assess whether portal usage affected the frequency of telephone calls, unscheduled provider visits and ER presentations .
Methods: Retrospective chart review of the electronic medical records (EMR) was performed for all patients undergoing elective endourology procedures by a single surgeon at a tertiary Urology referral center over a 1 year period (July 2017-July 2018). Procedures included Shockwave lithotripsy (SWL), Ureteroscopy (URS) and Percutaneous Nephrolithotomy (PCNL). Patient demographics, operative details, patient portal (MyChart) registration, patient initiated MyChart messages, telephone encounters, unscheduled provider (Urology or primary care physician) visits and ER presentations during a 1 month period before and after the procedure, were extracted from our EMR system (Epic, Verona, WI). Logistic regression analysis was performed to assess possible relationships between MyChart use and study outcomes.
Results: We identified 313 patients (200 MyChart users, 113 non-users) who underwent 374 procedures (SWL = 3, URS = 268, PCNL = 103). MyChart users were younger than non-users (mean age 56 vs 61, p=0.0011) and more likely to be married (69.5% vs 48.7%, p=0.0004). Mychart users made less provider telephone calls, both prior to (mean calls 1.1 vs 1.5, p=0.0037) and post procedure (mean calls 0.9 vs 1.3, p=0.021) and had less ER visits (8 vs 19, p=0.0002). On multivariable analysis, non-users of MyChart were 7.69 (95% CI 2.44-25) times more likely to have an unscheduled provider clinic visit (p=0.0004) and were 1.79 (95% CI 1.001-3.125) times more likely to have an ER visit
Conclusions: Patient portals enhance timeliness and efficiency in patient centered healthcare and have the immense potential to benefit patients undergoing surgical procedures. Our study has shown that patients undergoing Endourology procedures who use our patient portal make less telephone calls and are significantly less likely to make an unscheduled clinic or ER visit which will undoubtedly have a beneficial impact on their overall experience.