Too often, people living with HIV (PLHIV) face challenges, including additional health and psychosocial problems, that complicate self-care, like medication-taking and medical appointment attendance. Healthcare providers are not always aware when patients face these difficulties. A 'patient portal' is an online application that can give patients access to their medical records, appointment reminders, and questionnaires to inform providers about their health and wellbeing. Patient portals in HIV care can help providers detect patient problems and improve care. At the McGill University Health Centre's (MUHC) HIV care service, a survey showed great interest in a patient portal among both PLHIV and healthcare providers. Yet, little is known on how best to integrate a portal in HIV care settings and ensure it is accessible to patients. This project will be conducted at the MUHC's HIV care service in Montreal, Quebec which has over 2,000 patients. Participating patients will log on to a patient portal through a smartphone application and have a calendar of their HIV care appointments, health questionnaires to complete (previously chosen by people with HIV and healthcare providers), reminders for both and access to educational material. HIV physicians will be able to see their patients' questionnaire results to discuss them during clinic appointments. The project's objectives are to better understand what is needed to successfully integrate a portal in similar HIV practices with diverse patients and learn how acceptable and usable it is for HIV patients and doctors. The project will also examine how patient portal use impacts satisfaction, attendance, and physician detection of specific health problems. Furthemore, it will consider how patient sex, age, and ethnicity influence the results. People with HIV, providers, and staff at the study site will be involved in decision-making about this project. Over its 5-year duration, knowledge will be gained and shared on how to expand portal use efficiently and equitably in similar HIV care centers.
Confirmed living with HIV
Adult (at least 18 years old)
Literate in English or French
Patient at the study site
Cognitive impairment or medical instability that prevents participation
Insufficient mastery of French or English to participate (e.g., complete PROMs, study questionnaires)
Sequential
Patient portal with patient-reported outcome measure administration, appointment calendar and reminders, access to lab test results, and educational material
Other interventionPatients in the intervention will be trained to register on and use the patient portal. The following portal features will be used and studied in this project: the appointment calendar, PROMs administration, reminders (e.g., for appointments), educational materials, and access to personal lab results. Educational materials in the portal will include information on what to expect during HIV clinic visits, how to interpret HIV lab reports, and instructional videos on using the portal. Prior to visiting their HIV physician, patients will have continuous access to several portal features (calendar, education, and lab results, if applicable), and receive reminders (within 48 hours) of their clinic appointment and to complete the PROMs. Physicians will acquire their patients' PROM scores via the patient portal and receive training on how to do so. Patients and physicians are expected to review the PROM results and consider them during each clinic visit.
Acceptability of the intervention
Acceptability of the intervention is the primary implementation outcome. It will be measured with the Acceptability E-Scale. The minimum and maximum scores on this measure are 6 and 30, respectively, where higher scores mean greater acceptability.
Satisfaction with care
Satisfaction with care will be the primary effectiveness outcome measure. It will be assessed with the Short Assessment of Patient Satisfaction (SAPS) measure. The minimum and maximum scores on this measure are 0 and 28, respectively, where higher scores mean greater levels of patient satisfaction.
Technology usability -Ease of use
Technology usability is a secondary outcome for assessing the implementation. It will be measured in terms of Perceived ease of use (1 item, Single Ease Question). The minimum and maximum scores on this measure are 1 and 7, respectively, where higher scores mean greater ease of use.
Technology usability -Perceived usefulness
Technology usability is a secondary outcome for assessing the implementation. It will be measured in terms of Perceived usefulness. The minimum and maximum scores on this measure are 1 and 7, respectively, where higher scores mean greater perceived usefulness.
Technology usability -Attitude
Technology usability is a secondary outcome for assessing the implementation. It will be measured in terms of Attitude (likelihood to recommend the intervention). The minimum and maximum scores on this measure are 1 and 5, respectively, where higher scores mean a greater likelihood to recommend. Scores will be used to calulate the percentage of participants who are likely to recommend the intervention.
Feasibility of the intervention -Consent rate
Feasibility will be assessed to evaluate the implementation. It will be measured in terms of the Consent rate (the percentage of participants who consented amongst those who were eligible and approached).
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McGill University Health Centre/Research Institute of the McGill University Health Centre
Lead sponsor
Programme National de Mentorat sur le VIH et les Hépatites (PNMVH)
Collaborator
Portail VIH/sida du Québec
Collaborator
Assistance Publique - Hôpitaux de Paris
Collaborator
Unité de Soutien SSA Québec
Collaborator
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