Revising patient instructions following appointments led to 9.98% increase in online health portal activation

People sitting in front of computer

People sitting in front of computer

What was the challenge?

The use of electronic health records (EHRs) has the potential to yield benefits both patients and healthcare providers, and the Centers for Medicare and Medicaid Services (CMS) oversees Medicare and Medicaid EHR Incentive Programs to provide incentives for providers to adopt and demonstrate “meaningful use” of EHRs.

What was the program change?

Patients receive a paper After Visit Summary (AVS) containing medical details of the visit and instructions to activate their online patient portal account to access EHRs following visits to local health system providers. We redesigned the last page of the AVS to make benefits of EHR salient, highlight clear steps, and encourage action.

How did the evaluation work?

CMS implemented the redesigned AVS for all primary care clinics within the local health care system, while non-primary care providers and affiliates continued to use the original AVS.

What was the impact?

Initial analysis and estimates suggest that the revised AVS instructions led to a 9.98% increase in the probability that patients would activate their online portal account upon receiving their AVS.





Project Type

Impact evaluation of program change


Health and Human Services



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