Department of Population and Quantitative Health Sciences, Division of Biostatistics and Health Services Research; Department of Population and Quantitative Health Sciences, Division of Health Informatics and Implementation Science
Endocrine System Diseases | Health Information Technology | Health Services Administration | Health Services Research | Military and Veterans Studies | Nutritional and Metabolic Diseases
OBJECTIVE: The study sought to investigate whether consistent use of the Veterans Health Administration's My HealtheVet (MHV) online patient portal is associated with improvement in diabetes-related physiological measures among new portal users.
MATERIALS AND METHODS: We conducted a retrospective cohort study of new portal users with type 2 diabetes that registered for MHV between 2012 and 2016. We used random-effect linear regression models to examine associations between months of portal use in a year (consistency) and annual means of the physiological measures (hemoglobin A1c [HbA1c], low-density lipoproteins [LDLs], and blood pressure [BP]) in the first 3 years of portal use.
RESULTS: For patients with uncontrolled HbA1c, LDL, or BP at baseline, more months of portal use in a year was associated with greater improvement. Compared with 1 month of use, using the portal 12 months in a year was associated with annual declines in HbA1c of -0.41% (95% confidence interval [CI], -0.46% to -0.36%) and in LDL of -6.25 (95% CI, -7.15 to -5.36) mg/dL. Twelve months of portal use was associated with minimal improvements in BP: systolic BP of -1.01 (95% CI, -1.33 to -0.68) mm Hg and diastolic BP of -0.67 (95% CI, -0.85 to -0.49) mm Hg. All associations were smaller or not present for patients in control of these measures at baseline.
CONCLUSIONS: We found consistent use of the patient portal among new portal users to be associated with modest improvements in mean HbA1c and LDL for patients at increased risk at baseline. For patients with type 2 diabetes, self-management supported by online patient portals may help control HbA1c, LDL, and BP. Informatics Association 2021. This work is written by US Government employees and is in the public domain in the US.
Type 2, Veterans, diabetes mellitus, patient portals
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Copyright Published by Oxford University Press on behalf of the American Medical Informatics Association 2021. This work is written by US Government employees and is in the public domain in the US.
DOI of Published Version
Zocchi MS, Robinson SA, Ash AS, Vimalananda VG, Wolfe HL, Hogan TP, Connolly SL, Stewart MT, Am L, Netherton D, Shimada SL. Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration. J Am Med Inform Assoc. 2021 Sep 18;28(10):2176-2183. doi: 10.1093/jamia/ocab115. PMID: 34339500; PMCID: PMC8449618. Link to article on publisher's site
Journal of the American Medical Informatics Association : JAMIA
Zocchi MS, Robinson SA, Ash AS, Vimalananda VG, Wolfe HL, Hogan TP, Connolly SL, Stewart MT, Am L, Netherton D, Shimada SL. (2021). Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration. Population and Quantitative Health Sciences Publications. https://doi.org/10.1093/jamia/ocab115. Retrieved from https://escholarship.umassmed.edu/qhs_pp/1429
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