Table.

Summary Recommendations on Research and Reporting for Understanding Patient Engagement in Their Health Care Using Electronic Health Records

Research	Examples
Measure patients’ skills and interests in using digital health tools.	Understanding health and digital literacy oftarget users is critical to interpreting study results.
Use mixed-methods studies to determine usability and uptake.	User-centered design of portals will require gathering qualitative data about perceived barriers as well as observational evidence of navigational challenges.
Tailor portal interface and outreach to reach broad groups of patients, families, and caregivers.	Consider using audiovisual formats for data presentation to improve comprehension across literacy levels; translate tools into languages other than English.
Study the combination of digital tools with human support.	Initial in-person training and ongoing support can increase digital tool use; greater integration into existing provider and staff workflows will also reinforce patient support in using the tools.
Reporting
Incorporate implementation frameworks.	Frameworks such as RE-AIM may be particularly suited to understand processes and contextual factors that influence patient and caregiver use as well as provider and staff use.
Emphasize external validity alongside internal validity.	Report how and whether the approach could be tested in new or different populations.
Report effectiveness and use from multiple viewpoints.	Consider investigating a broader set of stakeholders in digital health research, including caregivers, peers, providers, staff, and system leadership.

RE-AIM = reach, effectiveness, adoption, implementation, and maintenance.