Appl Clin Inform 2021; 12(03): 539-550
DOI: 10.1055/s-0041-1730324
Research Article

The My Diabetes Care Patient Portal Intervention: Usability and Pre-Post Assessment

William Martinez
1  Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Amber J. Hackstadt
2  Department of Biostatistics, Vanderbilt University Medicine Center, Nashville, Tennessee, United States
Gerald B. Hickson
3  Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Thomas Knoerl
4  Upstate Medical University, State University of New York, Syracuse, New York, United States
S. Trent Rosenbloom
5  Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Kenneth A. Wallston
6  Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Tom A. Elasy
7  Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
› Author Affiliations
Funding This work was supported by NIDDK/NIH K23DK106511 and P30DK092986 and NCATS/NIH UL1TR000445. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.


Background My Diabetes Care (MDC) is a novel, multifaceted patient portal intervention designed to help patients better understand their diabetes health data and support self-management. MDC uses infographics to visualize and summarize patients' diabetes health data, incorporates motivational strategies, and provides literacy level–appropriate educational resources.

Objectives We aimed to assess the usability, acceptability, perceptions, and potential impact of MDC.

Methods We recruited 69 participants from four clinics affiliated with Vanderbilt University Medical Center. Participants were given 1 month of access to MDC and completed pre- and post-questionnaires including validated measures of usability and patient activation, and questions about user experience.

Results Sixty participants completed the study. Participants' mean age was 58, 55% were females, 68% were Caucasians, and 48% had limited health literacy (HL). Most participants (80%) visited MDC three or more times and 50% spent a total of ≥15 minutes on MDC. Participants' median System Usability Scale (SUS) score was 78.8 [Q1, Q3: 72.5, 87.5] and significantly greater than the threshold value of 68 indicative of “above average” usability (p < 0.001). The median SUS score of patients with limited HL was similar to those with adequate HL (77.5 [72.5, 85.0] vs. 82.5 [72.5, 92.5]; p = 0.41). Participants most commonly reported the literacy level–appropriate educational links and health data infographics as features that helped them better understand their diabetes health data (65%). All participants (100%) intended to continue to use MDC. Median Patient Activation Measure® scores increased postintervention (64.3 [55.6, 72.5] vs. 67.8 [60.6, 75.0]; p = 0.01).

Conclusion Participants, including those with limited HL, rated the usability of MDC above average, anticipated continued use, and identified key features that improved their understanding of diabetes health data. Patient activation improved over the study period. Our findings suggest MDC may be a beneficial addition to existing patient portals.

Author Contributions

W.M., A.J.H., S.T.R., K.A.W., and T.A.E. developed the concept and designed the study. Acquisition of data was done by W.M.. All the authors participated in the analysis and interpretation of data. W.M. drafted the manuscript. All the authors participated in critical revision of the manuscript for important intellectual content. W.M., A.J.H., G.B.H., T.K., S.T.R., and T.A.E. gave the final approval of the version to be published. W.M. was responsible for obtaining funding and supervised the study.

Protection of Human and Animal Subjects

The Vanderbilt University Institutional Review Board approved this study.

Kenneth A. Wallston passed away on October 27, 2020.

Supplementary Material

Publication History

Received: 08 November 2020

Accepted: 01 April 2021

Publication Date:
30 June 2021 (online)

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