P2.280: Improving patient portal activation, addressing disparity, and reducing waste in a rural pediatric subspecialty clinic using a quality improvement approach.

Purpose/Objectives: The sign-up process for our electronic patient portal (MyChart, Epic) at our regional clinic was not effective. Only 34% of our patients were enrolled as of November 2023. This represented a missed opportunity for our patients to engage in their health care. We initiated this quality improvement project to increase the MyChart activation percentage for all patients seen at Seattle Children’s Tri-Cities Cardiology Clinic from 34% to 65% by September 30th, 2025. Our free-standing clinic is located in Central Washington where the Hispanic population comprises between 15% to 66% of the total population, depending on the county.

Design/Methods: Using QI methodology, our multidisciplinary team (physician, registered nurses and family service coordinator) identified gaps in the MyChart registration process, staff commitment, workflow, and family awareness. We implemented multiple Plan, Do, Study, Act (PDSA) cycles. Interventions included standardizing our workflow to offer enrollment at the time of registration, educational materials, offering family counseling, and providing real-time enrollment assistance. MyChart activation percentage was the primary outcome measure, defined as the proportion of patients who have activated their MyChart account out of all eligible patients seen at our clinic in the prior 12 months. We tracked progress monthly, with the activation percentage extracted from our electronic medical record. To promote equitable care for our Spanish-speaking families, we implemented targeted strategies by spending additional time during their appointment and playing a video in Spanish to educate them about MyChart use and benefits. To improve immediate utilization, we encouraged patients and families to access their after-visit summary through MyChart. This had the measurable effect of minimizing reliance on paper-based processes.

Results: The overall MyChart activation percentage increased by 1.9-fold to 64% in February 2025 among all eligible patients. Among our Hispanic patients, activation percentage increased from 32% (January 2024) to 61% (February 2025). This compares to an increase from 39% to 68% among our non-Hispanic white during the same time frame. The most helpful interventions were counseling families about MyChart benefits and providing real-time enrollment assistance in the clinic. Additionally, we achieved resource savings by reducing the need for printed materials. This initiative resulted in an estimated decrease of 364 printed pages in January 2025, and 294 printed pages in February 2025, from our baseline estimated monthly paper usage of 1031 pages.

Conclusion/Discussion: Implementing systematic QI methodology increased MyChart activation percentage among our patients, both non-Hispanic white, and Hispanic. Secondarily, we reduced paper use by 30% and improved clinic efficiency. We are committed to decreasing care disparities by expanding our efforts for MyChart activation among our Spanish-speaking families and our broader Hispanic population. Our team aims to achieve our goal of 65% MyChart activation through additional PDSA cycles which will include transition of care education.