PROJECT SUMMARY There is increasing interest in promoting the use of information and communication technology to engage patients in their own healthcare. Patient portals, for example, can provide patients with secure access to lab test results, doctors’ notes, and medication lists, as well as facilitate communication with healthcare providers. Use of patient-facing tools like portals has been found to improve the overall quality of preventive or follow-up care, improve medication adherence and compliance with treatments, as well as reduce caregiver burden. Patients with the highest healthcare needs, such as older adults with multiple chronic conditions, stand to benefit the most from patient portals. However, multiple factors have been found to hinder older adults’ ability to fully optimize their use of these tools and their ability to retrieve and understand health information provided. Viewing lab test results is one of the most used features of patient portals, but older adult patients with limited health literacy and technology skills encounter the most problems locating and interpreting lab results. In this project, we will employ a user-centered approach to develop and evaluate a working prototype of LabGenie, a web-based patient engagement tool, specifically designed to improve older adults’ comprehension of lab results, and engagement in managing and acting upon their lab test results. LabGenie will provide visual representations of lab results and generate question prompts tailored and contextualized based on patients’ medical information. In Aim 1, we will use an iterative and user-centered approach focused on rapid prototyping and usability testing as guided by the patient engagement framework to design and test different prototypes of the LabGenie interface. In Aim 2, we will develop and incorporate in the full version of LabGenie, an AI-powered question prompt generation module that can automatically generate tailored question prompts based on personal health information from electronic health records and a lab test knowledge graph. In Aim 3, we will evaluate the effectiveness of LabGenie-generated question prompts in improving patient engagement and perceived self-efficacy and intentions to participate in shared decision making. In Aim 4, we will conduct an explanatory sequential mixed methods research on the full prototype to evaluate the effectiveness of the system in improving patient engagement, perceived ease of use, perceived usefulness, accessibility, and self-efficacy in shared decision making. We will also interview healthcare providers to elicit their perceptions about the potential impact of LabGenie on clinical workflow and burden in primary care settings. Our long-term goal is to apply these novel technologies and approaches in the design of patient decision aids or patient portals to improve patient engagement and shared decision making among at risk populations, with the ultimate goal of improving health outcomes.

PROJECT NARRATIVE Multiple factors have been found to hinder older adults’ ability to fully optimize their use of patient portals and their ability to retrieve and understand lab test results. In this project, we will employ a user-centered approach to develop and evaluate a working prototype of a patient-engagement tool called LabGenie specifically designed to aid older adults’ comprehension of lab results by providing visualizations of lab test results and tailored question prompts to help them prepare for follow-up consultations. Our long-term goal is to integrate these innovative technologies and approaches into patient portals and to conduct a large-scale randomized controlled trial to evaluate the efficacy of the enhanced system on improving older adults' self-management of chronic conditions.