Health equity research - MyChart activation
Clinical IT informaticists completed a preliminary data analysis highlighting gaps in MyChart adoption based on race, ethnicity, geographic location, and age (peds vs. adult). This data was presented to the ME&C (Marketing Engagement & Communication) and senior leadership at UCSF and BCH. As a result, ME&C identified this adoption gap as a critical opportunity during the OKR roadmap exercise. As a result, leadership designated resources to understand adoption challenges with identified patient segment groups.
Problem space
The latest data shows Latinx patients activate MyChart at ambulatory encounters only 58% of the time compared to White patients, who activate it 98% of the time. MyChart fast pass and other features can only be found on Mychart, which patients who don’t activate on Mychart can use.
Research objectives
Understand the contexts in which Limited English Proficiency (LEP), African American (AA), Latinx, and Asian American/Pacific Islander (AAPI) patients are being made aware of MyChart.
Understand barriers preventing identified patient segments from activating the MyChart application.
Understand what MyChart features these patients use most often and why.
Understand how identified patient segments communicate with UCSF clinical staff.
Hypotheses
LEP, AA, Latinx, and AAPI patients need clarification on MyChart activation steps.
Identified patient segments arrive at UCSF in considerable pain, and activating MyChart increases cognitive load.
Patient segments do not see the value in using the MyChart app.
Patient segments do not trust UCSF Health services.
Patient segments need more awareness of MyChart.
LEP patients face a language barrier when interacting with MyChart.
Role/Process
Developed research plan and discussion guide
Led patient interviews
Led synthesizing of interview data
Developed Insights and presentation shareout
Timeline
7-week study
Planning & Recruitment: 3 weeks
Patient interviews: 2 weeks
Analysis & Shareout: 2 weeks
Research overview
45min-1hr interviews
Most of our interviews were conducted over phone calls with the aid of an interpreter
Participants were compensated with a $50 gift card
Documenting the patient experience
I used the phases of a patient journey to apply data gathered from patient interviews.
Research findings
Most patients feel they are receiving excellent care because providers keep them informed about care treatments and procedures.
"Doctors and nurses and very responsible - care is very good. They explained everything very clearly to me."
-Patient: J.L.C
Patients are confused by the first-time UX on MyChart and find password recovery a barrier to activating MyChart.
" At first, I didn't understand. I'm not that good at English. It wasn’t until the second appt with Dr. Champ that I finally understood what I could do with it (when the Dr. explained).”
-Patient: J.C
User need: As a patient, when I use MyChart for the first time, I want more support so that I don’t feel confused.
Opportunity: How might we help patients feel more confident when using MyChart for the first time?
MyChart FTUE (First Time User Experience) presents challenges to patients understanding of how to use and navigate around MyChart.
Some patients have issues remembering their passwords during subsequent attempts at logging into MyChart and are frustrated by the password recovery process.
The English language and content in MyChart's UI are challenging for LEP during their FTUE.
Only one patient thought activating MyChart was easy to do.
Most patients rely on family members and doctors to help them understand how to use MyChart.
" On my second visit, the doctor taught me how to use MyChart, how to send messages, how to view test results. Dr. took 5-10 minutes to teach me.
-Patient: J.C
User need: As a patient, when I use MyChart, I want more support in learning how to use it so I feel more confident with the tool.
Opportunity: How might we help patients feel more confident about using MyChart on a regular basis?
Family members help patients learn how to use and navigate around MyChart, especially during first-time usage.
Doctors spend time explaining the benefits of MyChart and showing patients how to use it.
Most patients understand how to use core features in MyChart once they get past activation hurdles.
"If I forget where to go for an appointment, I'll go into MyChart to tell me where to go."
-Patient: J.C
Some patients find medical terminology and content on MyChart challenging to understand and take a long time to read.
"My daughter and RN helps me interpret test results.”
-Patient: B.A
User need: As a patient, when I view test results and AVS reports, I need content to be easier to understand so I don't need support from family or clinicians.
Opportunity: How might we simplify MyChart content for patients?
Some patients feel there are many medical terminologies, which can be challenging to understand.
One patient mentioned it takes her a long time to read her AVS reports.
Patients rely on family members to interpret test result data for them.
Recommended next steps
MyChart usability analysis and evaluative studies.
Perform a usability analysis of the MyChart application, focusing on the FTUE (First Time User Experience) onboarding experience.
Perform broader usability analysis of the MyChart application focusing on information architecture and navigation design.
Conduct a usability study of the MyChart application with Patients focusing on the onboarding experience.
Outcomes: Map out the current state of the MyChart application and document improvement opportunities.
Continue deeper research around the MyChart experience with a larger patient population size.
Work with the MyChart team to identify business cases to support greenlighting additional workstreams into solving Mychart adoption with identified patient segments.