{"id":{"repo_id":"msu","oai_identifier":"oai:d.lib.msu.edu:dnp_94"},"canonical_url":"https://search.dev.ndltd.org/etd/msu/oai:d.lib.msu.edu:dnp_94","repository":{"repo_id":"msu","name":"Michigan State University","base_url":"https://d.lib.msu.edu/oai"},"display":{"title":"DNP project : increasing patient portal engagement to promote disease self-management in a rural health clinic","abstract":"Background: Diabetes is a prevalent chronic condition, particularly in rural communities where limited resources, health disparities, and barriers to care contribute to poor disease control. Electronic patient portals have demonstrated potential to improve patient engagement, self-management, and health outcomes; however, utilization remains low in rural healthcare settings. Purpose: The purpose of this quality improvement project was to increase patient engagement with the electronic patient portal in a rural health clinic, with a primary focus on adult patients with type 2 diabetes. Methods: This project was guided by the Institute for Healthcare Improvement Model for Improvement using the Plan-Do-Study-Act (PDSA) framework. A multifaceted intervention was implemented over an eight-week period and included provider education, printed educational materials, in-clinic enrollment assistance by medical assistants, provider demonstrations of portal use, and biweekly patient portal messages. Pre- and post-intervention data were obtained from the electronic health record and included portal activation status and secure messaging activity. Results: The initial focus of diabetic patients only was changed to all patients due to inability to generate accurate reports for diabetics exclusively. Although the overall percentage of activated portal accounts declined during the implementation period, engagement among patients with active accounts increased modestly, as evidenced by secure messaging utilization. Barriers to new enrollment and sustained activation persisted despite implemented strategies. Conclusions: Improving patient portal utilization in rural populations is complex and multifactorial. Results suggest that focusing on sustaining engagement among existing portal users may yield short-term gains, while longer implementation periods and enhanced enrollment strategies may be necessary to achieve meaningful improvements in overall utilization and support chronic disease self-management.","abstract_html":"Background: Diabetes is a prevalent chronic condition, particularly in rural communities where limited resources, health disparities, and barriers to care contribute to poor disease control. Electronic patient portals have demonstrated potential to improve patient engagement, self-management, and health outcomes; however, utilization remains low in rural healthcare settings. Purpose: The purpose of this quality improvement project was to increase patient engagement with the electronic patient portal in a rural health clinic, with a primary focus on adult patients with type 2 diabetes. Methods: This project was guided by the Institute for Healthcare Improvement Model for Improvement using the Plan-Do-Study-Act (PDSA) framework. A multifaceted intervention was implemented over an eight-week period and included provider education, printed educational materials, in-clinic enrollment assistance by medical assistants, provider demonstrations of portal use, and biweekly patient portal messages. Pre- and post-intervention data were obtained from the electronic health record and included portal activation status and secure messaging activity. Results: The initial focus of diabetic patients only was changed to all patients due to inability to generate accurate reports for diabetics exclusively. Although the overall percentage of activated portal accounts declined during the implementation period, engagement among patients with active accounts increased modestly, as evidenced by secure messaging utilization. Barriers to new enrollment and sustained activation persisted despite implemented strategies. Conclusions: Improving patient portal utilization in rural populations is complex and multifactorial. Results suggest that focusing on sustaining engagement among existing portal users may yield short-term gains, while longer implementation periods and enhanced enrollment strategies may be necessary to achieve meaningful improvements in overall utilization and support chronic disease self-management.","abstract_has_math":false,"creators":["Weber, Angela (Angela Rose)"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Castine, Kristin L., 1959-"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-24T03:16:39Z","subjects":["Diabetics--Care","Information storage and retrieval systems--Medical care","Medical records--Data processing","Patient participation","Rural health","Self-care, Health"],"languages":["English"],"rights":["In Copyright"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["dnp:94","oclc:1601633870","local:R_5OHM7JrR202556h"],"render_values":[{"text":"dnp:94","href":null,"code":true},{"text":"oclc:1601633870","href":null,"code":true},{"text":"local:R_5OHM7JrR202556h","href":null,"code":true}]}]},"links":{"outbound_url":"https://doi.org/doi:10.25335/rman-h335","outbound_label":"DOI","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Castine, Kristin L., 1959-"]},{"key":"dc:creator","label":"Author","values":["Weber, Angela (Angela Rose)"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025"]},{"key":"dc:relation","label":"Dc Relation","values":["Doctor of Nursing Practice Projects"]},{"key":"dc:type","label":"Dc Type","values":["Text","Theses"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Diabetics--Care","Information storage and retrieval systems--Medical care","Medical records--Data processing","Patient participation","Rural health","Self-care, Health"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["English"]},{"key":"dc:rights","label":"Dc Rights","values":["In Copyright"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["dnp:94","oclc:1601633870","local:R_5OHM7JrR202556h","https://doi.org/doi:10.25335/rman-h335"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Background: Diabetes is a prevalent chronic condition, particularly in rural communities where limited resources, health disparities, and barriers to care contribute to poor disease control. Electronic patient portals have demonstrated potential to improve patient engagement, self-management, and health outcomes; however, utilization remains low in rural healthcare settings. Purpose: The purpose of this quality improvement project was to increase patient engagement with the electronic patient portal in a rural health clinic, with a primary focus on adult patients with type 2 diabetes. Methods: This project was guided by the Institute for Healthcare Improvement Model for Improvement using the Plan-Do-Study-Act (PDSA) framework. A multifaceted intervention was implemented over an eight-week period and included provider education, printed educational materials, in-clinic enrollment assistance by medical assistants, provider demonstrations of portal use, and biweekly patient portal messages. Pre- and post-intervention data were obtained from the electronic health record and included portal activation status and secure messaging activity. Results: The initial focus of diabetic patients only was changed to all patients due to inability to generate accurate reports for diabetics exclusively. Although the overall percentage of activated portal accounts declined during the implementation period, engagement among patients with active accounts increased modestly, as evidenced by secure messaging utilization. Barriers to new enrollment and sustained activation persisted despite implemented strategies. Conclusions: Improving patient portal utilization in rural populations is complex and multifactorial. Results suggest that focusing on sustaining engagement among existing portal users may yield short-term gains, while longer implementation periods and enhanced enrollment strategies may be necessary to achieve meaningful improvements in overall utilization and support chronic disease self-management.","Thesis (D.N.P.)--Michigan State University. Family nurse practitioner, 2026","Includes bibliographical references (pages 27-31)"]},{"key":"dc:format","label":"Dc Format","values":["44 pages"]},{"key":"dc:title","label":"Title","values":["DNP project : increasing patient portal engagement to promote disease self-management in a rural health clinic"]}]}],"canonical_facts":{"dc:contributor":["Castine, Kristin L., 1959-"],"dc:creator":["Weber, Angela (Angela Rose)"],"dc:date":["2025"],"dc:description":["Background: Diabetes is a prevalent chronic condition, particularly in rural communities where limited resources, health disparities, and barriers to care contribute to poor disease control. Electronic patient portals have demonstrated potential to improve patient engagement, self-management, and health outcomes; however, utilization remains low in rural healthcare settings. Purpose: The purpose of this quality improvement project was to increase patient engagement with the electronic patient portal in a rural health clinic, with a primary focus on adult patients with type 2 diabetes. Methods: This project was guided by the Institute for Healthcare Improvement Model for Improvement using the Plan-Do-Study-Act (PDSA) framework. A multifaceted intervention was implemented over an eight-week period and included provider education, printed educational materials, in-clinic enrollment assistance by medical assistants, provider demonstrations of portal use, and biweekly patient portal messages. Pre- and post-intervention data were obtained from the electronic health record and included portal activation status and secure messaging activity. Results: The initial focus of diabetic patients only was changed to all patients due to inability to generate accurate reports for diabetics exclusively. Although the overall percentage of activated portal accounts declined during the implementation period, engagement among patients with active accounts increased modestly, as evidenced by secure messaging utilization. Barriers to new enrollment and sustained activation persisted despite implemented strategies. Conclusions: Improving patient portal utilization in rural populations is complex and multifactorial. Results suggest that focusing on sustaining engagement among existing portal users may yield short-term gains, while longer implementation periods and enhanced enrollment strategies may be necessary to achieve meaningful improvements in overall utilization and support chronic disease self-management.","Thesis (D.N.P.)--Michigan State University. Family nurse practitioner, 2026","Includes bibliographical references (pages 27-31)"],"dc:format":["44 pages"],"dc:identifier":["dnp:94","oclc:1601633870","local:R_5OHM7JrR202556h","https://doi.org/doi:10.25335/rman-h335"],"dc:language":["English"],"dc:relation":["Doctor of Nursing Practice Projects"],"dc:rights":["In Copyright"],"dc:subject":["Diabetics--Care","Information storage and retrieval systems--Medical care","Medical records--Data processing","Patient participation","Rural health","Self-care, Health"],"dc:title":["DNP project : increasing patient portal engagement to promote disease self-management in a rural health clinic"],"dc:type":["Text","Theses"]},"updated_at":"2026-07-24T03:16:39Z"}