Academic Journal
Optimizing patient portal user interface boosts activation rates for Spanish-speaking pediatric patients and caregivers.
| Title: | Optimizing patient portal user interface boosts activation rates for Spanish-speaking pediatric patients and caregivers. |
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| Authors: | Chilukuri N; Stanford University School of Medicine, Palo Alto, CA, United States., Ballard E; Stanford Medicine Children's Health, Palo Alto, CA, United States., Xu X; Stanford Medicine Children's Health, Palo Alto, CA, United States., McPherson T; Stanford Medicine Children's Health, Palo Alto, CA, United States., Chug A; Stanford Medicine Children's Health, Palo Alto, CA, United States., Tse G; Stanford University School of Medicine, Palo Alto, CA, United States., Lee T; Stanford University School of Medicine, Palo Alto, CA, United States.; Stanford Medicine Children's Health, Palo Alto, CA, United States., Bassett HK; Stanford University School of Medicine, Palo Alto, CA, United States.; Stanford Medicine Children's Health, Palo Alto, CA, United States., Carlson JL; Stanford University School of Medicine, Palo Alto, CA, United States.; Stanford Medicine Children's Health, Palo Alto, CA, United States., Pageler N; Stanford University School of Medicine, Palo Alto, CA, United States.; Stanford Medicine Children's Health, Palo Alto, CA, United States. |
| Source: | Journal of the American Medical Informatics Association : JAMIA [J Am Med Inform Assoc] 2026 Apr 01; Vol. 33 (4), pp. 783-791. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 9430800 Publication Model: Print Cited Medium: Internet ISSN: 1527-974X (Electronic) Linking ISSN: 10675027 NLM ISO Abbreviation: J Am Med Inform Assoc Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2015- : Oxford : Oxford University Press Original Publication: Philadelphia, PA : Hanley & Belfus, c1993- |
| MeSH Terms: | Patient Portals* , User-Computer Interface* , Hispanic or Latino*, Humans ; Child ; Quality Improvement ; Female ; Caregivers ; Language ; Hospitals, Pediatric ; Electronic Mail |
| Abstract: | Objective: Patient portals (PP) can enhance healthcare access for pediatric patients and families but disparities persist among patients with diverse preferred languages. Our objective was to optimize the PP user interface and associated activation workflows to improve activation rates for pediatric families with Spanish as preferred language (Spanish-speaking patients and/or parents/guardians). Materials and Methods: A quality improvement intervention at a quaternary children's hospital optimized the PP activation user interface by redesigning the email/text activation messages, activation screen and error messages. The interventions were launched on August 3, 2023. Statistical process control charts were used to analyze patterns in activation rates, PP helpdesk calls, PP before and after the intervention implementation. Results: Of 38 575 patients with ambulatory visits in our study period, 8.4% were Spanish-speaking, 89.1% were English-speaking. There was a sustained increase in the monthly rate of newly activated PP accounts (43%-58%), decreased disparity between English- and Spanish-speaking patients by 7%, and a sustained increase in monthly rate of overall currently active PP accounts of Spanish-speaking patients (66%-69%) after interventions. There was a decrease in monthly number of helpdesk tickets due to activation issues and an increase in monthly number of incoming patient messages in Spanish per number of Spanish-speaking patients active on PP. Discussion: Optimizing the PP activation user interface and workflows by applying an equity-lens can help mitigate disparities in PP access. Conclusion: Future research is needed to implement and evaluate health system-community partnerships to mitigate the digital health divide. (© The Author(s) 2026. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Grant Information: | Dr Chilukuri is Stanford Maternal & Child Health Research Institute Fellow; Stanford Maternal & Child Health Research Institute; Stanford Maternal & Child Health Research Institute Fellow |
| Contributed Indexing: | Keywords: healthcare disparities; patient portal; pediatrics; quality improvement |
| Entry Date(s): | Date Created: 20260401 Date Completed: 20260714 Latest Revision: 20260714 |
| Update Code: | 20260715 |
| PubMed Central ID: | PMC13089549 |
| DOI: | 10.1093/jamia/ocaf228 |
| PMID: | 41921501 |
| Database: | MEDLINE |
| ISSN: | 1527-974X |
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| DOI: | 10.1093/jamia/ocaf228 |