Does "MyChart" Benefit "My" Surgery? A Look at the Impact of Electronic Patient Portals on Patient Experience

Purpose: Electronic patient portals can be beneficial in providing direct engagement and clarity to avoid unnecessary extra provider encounters. In this study we assessed whether portal usage among endourology patients affected telephone call frequency, unscheduled physician visits, emergency department presentations and complication rates. Materials and Methods: We conducted a retrospective chart review of patients undergoing elective endourology procedures by a single surgeon at a tertiary urology center from July 2017 to July 2018. Patient demographics, operative details, patient portal (MyChart) registration, patient initiated MyChart messages, telephone encounters, unscheduled physician visits and emergency department presentations during a 1-month period before and after the procedure were identified. Logistic regression analysis assessed relationships between MyChart use and study outcomes. Results: We identified 313 patients (200 MyChart users, 113 nonusers) who underwent 374 procedures. MyChart users were younger (age 56 vs 61, p=0.0011) and more likely to be married (69.5% vs 48.7%, p=0.0004). MyChart users made fewer telephone calls before (1.1 vs 1.2, p=0.005) and after procedure (0.9 vs 1.3, p=0.029), and had fewer emergency department visits (8 vs 18, p=0.0005) than nonusers. On multivariable analysis MyChart nonusers were 4.55 (95% CI 1.92-11.11) times more likely to have an unscheduled clinic visit (p=0.0006), 1.92 (95% CI 1.075-3.333) times more likely to have an emergency department visit (p=0.028) and 2.7 (95% CI 1.43-5.26) times more likely to have a postoperative complication (p=0.0026). Conclusions: Patients undergoing endourology procedures who use MyChart make fewer telephone calls and are significantly less likely to have an unscheduled clinic/emergency department visit or a complication.