Check-In Check-Up: Analyzing and Improving Pre-Appointment Engagement in a Primary Care Clinic at UVA Health System

The UVA Health System utilizes a cloud-based electronic medical record (EMR) platform, featuring a secure patient portal that helps patients manage their health. This portal empowers users by enabling them to complete key health tasks, such as communicating with their care team, accessing health records, and coordinating appointments. This project focuses on increasing pre-appointment engagement through the patient portal to enhance the patient experience at a primary care clinic (PCC) within UVA Health.Patients can be assigned multiple types of pre-appointment tasks via the portal. One task, referred to as eCheck-In, is available to all patients prior to their appointment. This allows patients to complete necessary paperwork before their appointments, which streamlines visits. However, eCheck-Ins were completed for only 35.3% of patient encounters in 2024 at the PCC. To gather insights into this issue, an online survey was distributed to PCC patients to assess portal usage and the existing eCheck-In experience. Major themes emerged including issues of redundancy, poor technological literacy, and underutilization of the patient portal mobile app. Success in prior studies and support from the clinic’s providers suggest piloting a volunteer-led education program for eCheck-In and general patient portal support.Another type of pre-appointment task is specific to Medicare Annual Wellness Visits (AWV) where patients complete a comprehensive pre-visit questionnaire to streamline appointments and update providers on their annual health. By completing this questionnaire in advance of their appointments, patients and providers can collaborate more effectively to develop or update a personalized prevention plan, ensuring a more meaningful and efficient visit. For the previous two years at the PCC, the completion rate for pre-visit AWV questionnaires was just 50.1%.In 2023, one PCC provider implemented a new strategy to try and personally increase their patients’ completion rates of the AWV questionnaire. This strategy included personalized direct messages sent from the provider to their patients. Our analysis of this new strategy found that the provider significantly improved the completion rate among their patients by 18.6%. This strategy optimized their workflow, enhanced patient engagement, and improved overall visit quality.This strategy, and other findings in this paper, could be broadened to other providers, clinics, and medical centers to ensure a more efficient, effective, and equitable healthcare experience for all.