The Annual Wellness Visit Health Risk Assessment: Potential of Patient Portal-Based Completion and Patient-Oriented Education and Support
Danielle S Powell, Mingche M J Wu, Stephanie Nothelle, Kelly Gleason, Esther Oh, Hillary D Lum, Nicholas S Reed, Jennifer L Wolff- Life-span and Life-course Studies
- Health Professions (miscellaneous)
- Health (social science)
Abstract
Background and Objectives
Patient portals are secure online platforms that allow patients to perform electronic health management tasks and engage in bidirectional information exchange with their care team. Some health systems administer Medicare Annual Wellness Visit (AWV) health risk assessments through the patient portal. Scalable opportunities from portal-based administration of risk assessments are not well understood. Our objective is twofold— to understand who receives vs. misses an AWV and health risk assessment and explore who might be missed with portal-based administration.
Research Design and Methods
This is an observational study of electronic medical record and patient portal data (10/03/2021-10/02/2022) for 12,756 primary care patients 66+ years from a large academic health system.
Results
Two-thirds (n=8,420) of older primary care patients incurred an AWV; 81.0% of which were active portal users. Older adults who were active portal users were more likely to incur AWV than those who were not, though portal use was high in both groups (81.0% with AWV vs. 76.8% without; p<0.001). Frequently affirmative health risk assessment categories included falls/balance concerns (44.2%), lack of a documented advanced directive (42.3%), sedentary behaviors (39.9%), and incontinence (35.1%). Mean number of portal messages over the 12- month observation period varied from 7.2 among older adults affirmative responses to concerns about safety at home to 13.8 for older adults who reported difficulty completing activities of daily living. Portal messaging varied more than two-fold across affirmative health risk categories and were marginally higher with greater number affirmative (mean=13.8 messages/year no risks; 19.6 messages/year 10+ risks).
Discussion and Implications
Most older adults were active portal users— a group more likely to have incurred a billed AWV. Efforts to integrate AWV risk assessments in the patient portal may streamline administration and scalability for dissemination of tailored electronically mediated preventive care but must attend to equity issues.