# Improving Diabetes Care through Effective Personalized Patient Portal Interactions

> **NIH VA I01** · EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL · 2021 · —

## Abstract

Abstract
Currently over 3 million Veterans have adopted the VA Patient Portal, My HealtheVet (MHV), however actual
use of the portal varies considerably, and we have little data on how the portal features can best improve
patient outcomes, or whether effective use varies by subgroups. We will work to define effective use, using
clinical and administrative data, coding of secure messages, patient surveys, and in-depth interviews with
extensive MHV experience. Lessons from this work will be used to refine an intervention to support effective
use of MHV portal features for chronic disease management. We have chosen to anchor our research in a
particular disease area: Type 2 diabetes, a complex disease affecting many Veterans associated with
significant mental and physical comorbidities, complications and negative outcomes, and requiring high levels
of self-management.
Among a national sample of Veterans with uncontrolled diabetes, Aims 1 and 2 use a cohort-with-nested-case-
control design to generate needed information to personalize interventions and to define effective use of the
patient portal. Aim 3 is a small-scale experiment designed to test a MHV supported adoption intervention.
Our Specific Aims are to:
Aim 1. Generate new information for feature selection and personalizing interventions.
 In a national longitudinal cohort of Veterans with uncontrolled type 2 diabetes, we will test the
 association of patient portal tool use with improvements in physiologic measures of control (H1a), and
 the association will differ for patients with mental health conditions and those in rural areas (H1b).
Aim 2. Generate details about how patients are effectively using the patient portal.
 We will collect data on patients with good glycemic (HbA1c) control (cases) and with poor control
 (controls). Using surveys and secure message coding, we will examine differences in communication
 with the clinical team (information sharing, information seeking, socio-emotional exchange), and in
 sharing information from their portals with family and/or non-VA providers.
Aim 3. Conduct a small-scale experiment, using a randomized encouragement design, to test the feasibility of
 engaging Veterans in supported adoption intervention to promote effective MHV use, in a sample of
 200 Veterans with diabetes (with or without comorbid mental health problems)
For Aim 3, we will design a supported adoption intervention leveraging the features associated with the
greatest evidence in Aims 1 and 2, seek feedback on the intervention from key stakeholders (e.g., primary care
providers, staff, Veterans with diabetes), and then randomize patients at the Bedford/Boston VAMCs to be
invited to participate in the intervention. Evaluation will focus on impact on increased use of MHV and
feasibility of conducting a large scale implementation of the refined intervention in a future IIR.
This research will develop and test an intervention to improve diabetes care, while strengthening the evide...

## Key facts

- **NIH application ID:** 9757715
- **Project number:** 5I01HX002100-03
- **Recipient organization:** EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL
- **Principal Investigator:** Stephanie Leah Shimada
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-02-01 → 2021-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9757715

## Citation

> US National Institutes of Health, RePORTER application 9757715, Improving Diabetes Care through Effective Personalized Patient Portal Interactions (5I01HX002100-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9757715. Licensed CC0.

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