Patient portal engagement for cancer genetic services linked to prior healthcare interactions in RCT
This randomized controlled trial enrolled 3,073 primary care patients aged 25-60 years from the University of Utah Health and NYU Langone Health systems who met family history-based criteria for cancer genetic evaluation. The intervention involved sending patient portal messages with a hyperlink to a pretest genetics education chatbot or information about scheduling a standard of care appointment, compared to information about scheduling alone. The primary outcome was opening these messages and beginning genetic services.
Analysis showed that opening patient portal messages was positively associated with the number of previous patient portal logins (average marginal effect [AME] 0.32 at UHealth, 0.33 at NYULH), having a recorded primary care provider (AME 0.15 at NYULH), and more primary care visits in the previous 3 years (AME 0.09 at NYULH). Similarly, beginning pretest genetic services was associated with more previous logins (AME 0.14 at UHealth, 0.18 at NYULH), having a recorded provider (AME 0.08 at NYULH), and more primary care visits (AME 0.07 at NYULH). All reported confidence intervals excluded zero, indicating statistical significance.
Safety and tolerability data were not reported. The study's practice relevance suggests that patients already interacting with the healthcare system may be most likely to respond to digital outreach for genetic services, and that addressing barriers to accessing healthcare and technology may be necessary to increase broader engagement. Key limitations of the study design and potential confounding factors were not detailed in the provided evidence.
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