To evaluate satisfaction with the healthcare provider report (HPR) from a migraine smartphone app (Vega), and its impact on provider confidence in decision-making in simulated patient portal communications.

Patient portals of many electronic health records (EHRs) allow patients to securely send time-sensitive questions to providers, who frequently require further clarifying questions following EHR review to make informed decisions. Vega allows patients to log migraine-related data and medication usage in real-time and compile these into an HPR to facilitate patient-provider communication and decision-making confidence in care.

Twelve Mass General Brigham providers (neurologists and primary care) received 10 standardized simulated cases mimicking typical patient portal communications after an initial visit, accompanied by EHR data (medical history, physical, laboratory/imaging data, and initial assessment and plan). For each provider, cases were randomized 1:1 so that half included a Vega HPR. Providers sent their medical decisions to a proctor, who provided additional information if requested. After each case, providers scored their confidence in their decision and satisfaction with the Vega HPR on a 5-point Likert scale (5=most confident /satisfied). Mean confidence scores of the Vega HPR and Non-HPR groups were compared using a linear mixed effect model, and mean satisfaction score for the Vega HPRs was calculated.

The mean confidence scores for Non-HPR and Vega HPR cases were 3.88 (95% CI, 3.53-4.23) and 4.40 (95% CI, 4.05-4.75), respectively. The difference between means was 0.517 (95% CI, 0.21-0.83, p=0.0013), demonstrating that access to a Vega HPR improved provider confidence in their medical decision. Mean satisfaction with the Vega HPR was 4.633 (SD 0.663, IQR 1, median 5) out of 5, indicating high satisfaction with the reports.

Providers responding to simulated patient portal encounters with the additional Vega HPR data were more confident in their decision-making and reported a high level of satisfaction with the HPR.