Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Karen Burritt PhD, RN

Second Advisor

Della Hughes, DNP, RN

Third Advisor

Sylvia Simons, DNP, RN


Introduction: Stage three of Meaningful Use (MU) is currently underway and is focused on promoting patient portal use. If the electronic medical record patient portal use is less than 25%, primary care providers face reductions in value-based reimbursements. National adoption rates from portal use remain under 27% with some providers averaging well below the needed 25%. The following practice question is proposed, “In a low-income urban adult clinic, how does an interactive electronic education intervention compared to no education intervention affect patient portal adoption rates?”

Objectives: The purpose of this project is to identify whether an electronic patient educational video and self-service kiosk will increase the use of portals among low income older adults in a primary care office. The overreaching goal of the proposed project is to increase patient portal adoption to the MU requirement of 25% of participants by March 4, 2019.

Methods: A convenience sample of 1,894 adult patients attending a primary care appointment is expected. A retrospective data analysis will be used to gather pre and post-intervention portal adoption percentages. Data will be compared using chi-square methodology. Demographic information will be used for descriptive statistics. Survey data will be used to capture study learnings and to evaluate the intervention. In this quality improvement project, data will be collected from persons receiving a primary care appointment at the clinic that participate in the patient education video and self-serve kiosk over a 84-day period. The rate of portal adoption for persons using the video and kiosk will be compared to the portal adoption rate before the video was available. Additional, de-identified demographic information will be collected in order to understand if there are differences in portal adoption among patient types.

Results: It is predicted that patient portal use rates will reach 30% in response to the evidence-based intervention.

Conclusions: It is expected that the proposed workflow changes with an educational intervention will eliminate the barrier of a lack internet access and will thus increase patient portal rates.

Implications: The vision of the proposed project is to be cycle one of many cycles. With the clinic’s vast number of students and support of educational staff, this project can provide a framework for future quality improvement projects aimed at improving patient portal use and patient outcomes.