· Executive Brief
Health Empowerment Day 2026
Use the observance to review how people find information, enter the right route, and remain connected through follow-through.
Leadership signal
Recognition becomes useful when leaders inspect the real route.
The strongest use of the observance is operational. Map where questions enter, how requests move, when ownership changes, and how unresolved work becomes visible. The goal is not to make a clinical claim. It is to make the organization’s response easier to understand and manage.
Start by distinguishing what is known from what the organization still needs to learn. A campaign plan, communication volume, or meeting count does not establish that a route is usable. Leaders need direct listening, clear ownership, locally defined measures, and a method for keeping exceptions visible.
Executive opening
Empowerment is an operating capability, not a slogan
Health systems increasingly ask patients to act for themselves. They schedule online, check test results through a portal, join video visits and complete assessments before appointments. Each of those steps assumes a patient who has the skills, devices and confidence to finish it. When any step fails, the visit, result or follow-up it supports can fail with it.
Many patients are not there yet. In a national survey of 12,865 U.S. adults, 65.2% used patient portals and 38.4% used synchronous telehealth.[2] Older Black patients were less likely to use portals, and older adults with more frequent care were also less likely to use them.[2] The people with the greatest need for coordinated care may therefore be the least connected to digital routes.
Even patients who say they are active users may not finish what the system asks. In a primary care study of older adults, 80% self-reported using the portal at least 12 times a year.[14] Yet health record data showed that only 47% of those assigned a portal-based medication assessment completed it.[14]
Empowerment therefore depends on infrastructure. Digital navigators, plain-language design, proxy access for care partners, and reliable responses to messages all determine whether activation is real. Each is an operating decision with an owner, a budget and a measure. This brief adds the research base to the executive guidance already on this page.
The sections below cover the evidence on portal use and activation, the continuum from enrollment to follow-up, access and the digital divide, equity, the navigator workforce and communication. Throughout, the focus is on what an organization controls rather than on what patients should do differently.
Current evidence
What the research says about portal use, activation and skills
Portal adoption is broad but shallow in places. The national survey analysis found that age alone was not a significant factor once other variables were considered.[2] Older adults who completed the survey online were more likely to use portals than those who used a paper form.[2] Familiarity with technology, not birth year, appears to be the stronger marker. That distinction matters because experience can be built, while age cannot be changed.
Skills are measurable and specific. In an urban safety-net health system, researchers observed 64 patients aged 50 or older as they tried four digital tasks.[7] Independent completion was 74% for launching a video visit and 52% for reaching a website from a link.[7] It was 71% for logging in to the portal and 70% for signing up for an account.[7] Non-English language preference, lower education and access to cellular data only were associated with needing help or not completing tasks.[7]
Activation can change with structured support. In a longitudinal study of 140 newly diagnosed adults with type 2 diabetes in Jordan, mean Patient Activation Measure scores rose from 44.7 at baseline to 60.0 at six months.[11] Better activation was significantly associated with higher medication adherence and lower HbA1c.[11] Mean HbA1c fell from 10.6% at baseline to 8.7% at six months over the same period.[11] The design was observational, so the association does not show that activation alone produced the change.
Tailoring support to activation level also shows promise. A quasi-experimental study in a Saudi university family medicine center ran from November 2024 to June 2025 with an estimated sample of 65 patients.[12] Activation improved significantly in the intervention group, particularly among patients who began at the lowest levels, while scores in the control group declined.[12] No significant short-term changes appeared in blood pressure, glucose or cholesterol.[12]
Health literacy is also modifiable. In a multidisciplinary primary care pain program, 43 participants completed the full intervention.[13] Statistically significant improvements appeared in five health literacy domains by midpoint and eight by the end.[13] The domain for navigating the health care system improved significantly across all time-point comparisons.[13] That domain is the one most directly shaped by how a health system designs its routes. Activation and literacy are therefore outcomes the organization can influence and should measure.
Figure 1
Many patients cannot complete the digital steps systems now require
Percent of patients completing or using each digital step, as defined in each study. Values are copied from the cited studies [2], [7], [14], [15]; none is estimated.
Data note. These values come from different studies, populations and definitions, so this is an indirect comparison; only the three task values from the same safety-net study can be compared directly.
Limitation. Samples range from 32 to 12,865 people; the national figure is self-reported, while the task and assessment figures were observed or drawn from records.
Figure data (6 rows)
| Measure | Value | Population, setting and year as reported | Source |
|---|---|---|---|
| Used a patient portal in the past 12 months | 65.2% | 12,865 U.S. adults, national survey cycles 6 and 7 | [2] |
| Launched a video visit independently | 74% | 34 of 46 patients aged 50 or older, urban U.S. safety-net system | [7] |
| Logged in to the portal independently | 71% | 44 of 62 patients, same study | [7] |
| Reached a health website from a link independently | 52% | 31 of 60 patients, same study | [7] |
| Completed a portal-based pre-visit medication assessment | 47% | 15 of 32 older adults in the intervention arm, one primary care health center | [14] |
| Patients with dementia who had a registered care partner with shared access | 10.41% | 3,170 patients aged 65 or older, one academic health system, 2017 to 2022 | [15] |
Continuum of care
Where activation breaks between enrollment and follow-up
Patient empowerment follows a chain: awareness, account creation, first login, routine use, and acting on what the portal shows. Each link has a different owner, and the research suggests that the weakest links appear after enrollment rather than before it. Executives tend to track the early links, such as accounts created, because they are easy to count. The later links, where patients act on information, are where outcomes are won or lost.
Account activation is not the same as task completion. The portal-based medication study enrolled 64 older adults with multiple chronic conditions.[14] Assessments were sent several days before visits, and identified challenges were routed to the primary care physician.[14] Fewer than half of the intervention patients completed the assessment, and the authors concluded that further adaptation was needed to ensure patients access their accounts.[14]
Response reliability is the second weak link. A survey in an academic geriatric primary care practice received responses from 786 of 3,850 invitees, a rate of 20.4%.[1] Most patients (54.5%) and caregivers (59.8%) expected replies within one business day or faster.[1] Of the respondents, 683 were patients and 103 were caregivers.[1] Negative themes included delayed or inadequate responses and replies from non-physician staff.[1] Expectations that are not met can undo the confidence that activation programs try to build. Caregivers also messaged more often than patients did.[1]
Care partners are part of the continuum whether systems plan for them or not. In a five-year cohort of 3,170 patients aged 65 or older with diagnosed dementia, 71.20% were registered portal users.[15] Only 10.41% had a registered care partner with shared access.[15] Yet care partners wrote 63.09% of message threads, and 97.13% of those partners used the patient’s own login.[15]
Those findings describe a handoff that exists informally but is not recorded. When a care partner uses the patient’s credentials, the clinical team cannot tell who is reading results or asking questions. The authors called for organizational initiatives that encourage awareness, registration and use of proper shared or proxy access.[15] That is an operations task for registration, health information management and clinic staff, not a patient education task alone. Registration staff can offer proxy access at the moment a care partner is first identified.
Figure 3
Why the pathway breaks
People
- Limited digital skills and prior online experience
- Navigator training lacks health-care-specific content
- Clinicians skeptical of tools that do not fit workflow
Process
- No screening or referral to digital navigation
- Pre-visit assessments sent without follow-up when incomplete
- Care partners not offered proxy access at registration
Technology
- Learnability and operability barriers in tool design
- Tasks available only in English
- Cellular-only or no internet access
Environment
- Homebound status and limited broadband
- Patients feeling compelled to adopt portals
- Privacy concerns about information online
Policy
- Unclear reimbursement for digital navigation
- Portal-only routes with no staffed alternative
- Message response standards not defined
Measurement
- Account counts used in place of task completion
- Results not stratified by age, race or language
- Care partner messages hidden behind patient logins
Unranked qualitative cause-and-effect diagram for the outcome in the box: Patients enrolled in digital tools do not complete the tasks that support self-management and follow-up Causes are assembled from the cited literature [7], [10], [9], [14], [15], [3], [5], [6], [8], [2]; categories are not weighted and their order carries no meaning.
Data note. Qualitative; no frequencies are implied.
Limitation. Causes drawn from published studies may not all apply locally; validate them with frontline teams.
Figure data (6 rows)
| Category | Causes drawn from the cited literature |
|---|---|
| People | Limited digital skills and prior online experience; Navigator training lacks health-care-specific content; Clinicians skeptical of tools that do not fit workflow |
| Process | No screening or referral to digital navigation; Pre-visit assessments sent without follow-up when incomplete; Care partners not offered proxy access at registration |
| Technology | Learnability and operability barriers in tool design; Tasks available only in English; Cellular-only or no internet access |
| Environment | Homebound status and limited broadband; Patients feeling compelled to adopt portals; Privacy concerns about information online |
| Policy | Unclear reimbursement for digital navigation; Portal-only routes with no staffed alternative; Message response standards not defined |
| Measurement | Account counts used in place of task completion; Results not stratified by age, race or language; Care partner messages hidden behind patient logins |
Access
Closing the digital divide with training, not only devices
Access to digital care depends on devices, broadband, prior experience and help. Providing one of these without the others often falls short. Leaders should treat digital access as a set of linked requirements rather than a single purchase. Each requirement also has a different owner inside the organization, from supply chain to clinical education.
A national study of 653 homebound Medicare beneficiaries during the pandemic tested those links directly.[3] Access to devices was associated with eHealth use at first, but the association became nonsignificant after accounting for prior online experience and training.[3] Training with assistance significantly predicted video telehealth use and use of both portals and video.[3] The authors concluded that devices alone may be insufficient to reduce disparities among homebound older adults.[3] Prior online experience, in turn, significantly predicted patient portal use.[3]
Usability is the other half of access. The safety-net observation study separated fundamental skill gaps from design barriers in the tools themselves.[7] It coded usability problems as six learnability challenges and three operability challenges.[7] The authors urged health systems to distinguish skill gaps from usability barriers because each requires a different response.[7] They also called on vendors to co-create tools with historically excluded users.[7]
Digital navigation is already common in some settings. A mixed-methods study of California safety-net primary care surveyed 50 participants representing 35 practices.[8] Of those participants, 80% reported that their health system had implemented or attempted digital navigation in some form.[8] Interviews identified five models, ranging from an integrated staff role and information technology support to dedicated navigators, volunteer partners and a rural access hub.[8] Each model trades cost, reach and clinical integration differently, so the choice depends on the population served. Rural clinics, for example, may need an access hub where urban clinics can embed the role in front-desk work.
The same study named the main barriers. Clinics reported unmet need for devices and broadband, limited staff buy-in and digital literacy, and the lack of data-driven screening and referral programs.[8] The authors argued that advocacy for device and broadband access and for reimbursement will be critical to sustainability.[8] For executives, the referral gap is the most actionable finding, because it is a workflow the organization can build itself. A simple screening question at registration or rooming could identify patients who need help before a digital task fails.
Executive guidance · System route
Map the path from first contact to verified follow-through.
Use this route as a discussion framework. Replace each stage with the organization’s approved process, qualified roles, current service capacity, and applicable requirements. Do not infer a clinical protocol from the observance title.
The route at a glance
- Listen
- Clarify entry
- Coordinate the partner route
- Protect transitions
- Verify and learn
Reliability rule: Every stage needs a named owner, an observable status, an approved escalation path, and a defined signal that shows whether responsibility moved or remained unresolved.
Listen
Gather questions and friction points from people using the route, frontline teams, and community-facing staff. Separate observed barriers from assumptions.
Clarify entry
Publish a plain-language first step and identify who receives requests through each approved channel.
Coordinate the partner route
Align internal teams and external partners around one current message, real entry point, receiving owner, escalation path, and follow-through signal.
Protect transitions
Use acknowledgment and status visibility when responsibility moves between services, locations, or organizations.
Verify and learn
Review unresolved work, repeat contacts, and avoidable handoffs. Use the findings to improve the route rather than blame individuals.
Figure 2
The system route as one flow
The five stages of the system route described in this brief, drawn as one flow with a learning loop back to the start. The stages are the page’s original executive guidance, not a clinical protocol.
Data note. Shows sequence and handoffs only; it carries no counts or rates.
Limitation. Local processes may add, merge or reorder stages under organizational policy.
Figure data (5 rows)
| Stage | What the stage requires |
|---|---|
| Listen | Gather questions and friction points from people using the route, frontline teams, and community-facing staff. Separate observed barriers from assumptions. |
| Clarify entry | Publish a plain-language first step and identify who receives requests through each approved channel. |
| Coordinate the partner route | Align internal teams and external partners around one current message, real entry point, receiving owner, escalation path, and follow-through signal. |
| Protect transitions | Use acknowledgment and status visibility when responsibility moves between services, locations, or organizations. |
| Verify and learn | Review unresolved work, repeat contacts, and avoidable handoffs. Use the findings to improve the route rather than blame individuals. |
Equity and trust
Who is left out when care moves online
Digital routes can widen gaps that already exist. In the national survey, older Black or African American patients were less likely to use patient portals, and these age-specific patterns appeared only for portals, not for synchronous telehealth.[2] A system that shifts communication to the portal without an alternative may therefore shift disadvantage as well. The difference between the two channels suggests that offering more than one route can matter.
Language and connectivity matter at the task level. In the safety-net study, participants spoke English, Spanish or Cantonese, and instructions were given in their preferred language while tasks were performed in English.[7] Minoritized race and ethnicity, non-English language preference and lack of a portal account were all associated with needing assistance or not completing tasks.[7] Vendor contracts can require multilingual interfaces and testing with patients who prefer languages other than English.
Patients describe these barriers in their own words. Interviews with 66 joint replacement patients found that older adults struggled with digital literacy and unfamiliar technology.[6] Limited internet access was an obstacle, patients with language barriers reported accessibility problems, and some worried about personal information being online.[6] The authors warned that such patients face greater risk of ineffective communication with care teams and delayed follow-up appointments.[6] Some patients also doubted that portals would be useful to them.[6]
Trust is shaped by how patients first meet the technology. Interviews with 31 adults aged 60 or older during the pandemic found that some felt compelled to use portals.[5] Patients who lacked a strong intention to use the portal tended to focus on difficulties rather than usefulness.[5] The authors recommended training and education tailored to older adults.[5] Mandated adoption without readiness can weaken the intention that sustains use.
Equity review should therefore look at task completion, not just account counts. Stratifying portal activation, video visit completion and message response times by age, race, language and connectivity will show where the route fails. Offering a staffed alternative for people who cannot or will not use digital channels is part of the same commitment. Telephone scheduling, mailed results and in-person help should remain easy to find. Choice, rather than mandate, is what preserves trust. Results should go to the same committee that reviews other access measures, so digital gaps are not treated as a technology issue alone.
Human infrastructure
Digital navigators and the clinicians who make tools usable
Digital tools do not run themselves. They depend on navigators who teach skills, front-desk staff who enroll patients, clinicians who answer messages and information technology teams who fix problems. The research suggests that this human layer is often undertrained and unevenly funded. Each role needs a defined scope, a manager and protected time. Without those, digital support becomes an unplanned extra duty for whoever is closest to the patient.
Training for the navigator role is still immature. A pragmatic review identified 38 unique results for digital navigator training and examined 9 programs in detail.[10] All 9 covered technological support, but fewer covered health-care-specific competencies.[10] Only one included trainer-led evaluation of soft skills.[10] The authors suggested role-play, durable troubleshooting skills, volunteer pipelines and upskilling existing health care staff.[10] The search drew on general web sources and a digital inclusion guide, which limits its reach.[10] Its finding is consistent with the staff digital literacy gaps reported in California safety-net clinics.[8]
Clinician attitudes shape adoption. A mixed-methods study surveyed 69 clinicians in integrated primary care about mobile health apps.[9] Two groups emerged: 25 enthusiasts and 44 skeptics.[9] Enthusiasts emphasized clinical fit and workflow solutions such as health record integration and digital navigator roles.[9] Skeptics cited liability, relational concerns and equity barriers such as device access and digital literacy.[9] Both groups saw apps as adjuncts rather than replacements for care.[9]
Those findings suggest that persuasion is not the main lever. The authors concluded that adoption depends less on persuasion than on enabling technical, organizational and ethical conditions.[9] For executives, that means investing in integration, clear message-handling roles and navigator capacity rather than in more mandates. Curated app lists, boundary-setting norms and equity-first implementation were among the strategies the study identified.[9]
Message workload belongs in this plan as well. In the geriatric practice survey, 12.6% of caregivers sent messages weekly or more, compared with 6.1% of patients.[1] Patients and caregivers valued convenient communication and the ability to avoid in-person care.[1] The authors called for interventions that support portal use while minimizing burdens on clinicians.[1] Staffing and routing of portal messages are therefore part of the empowerment budget. Clear rules on who answers which message type can reduce both delays and clinician burden.
Executive guidance · Operating dashboard
Measure whether the operating route works as intended.
Do not publish a number until the organization defines its numerator, denominator where relevant, owner, source system, exclusions, review cadence, and limits. The candidates below are management prompts, not benchmarks or reported results.
Four operating signals
Each signal pairs an executive question with one candidate local measure, set out below.
Executive guidance · Signal
Entry-point clarity
Can people and staff identify the approved first step without searching across conflicting instructions?
- Candidate local measure
- Locally defined contact, routing, and repeat-contact signals by channel and service.
Executive guidance · Signal
Ownership reliability
Does a specific team accept each request and make its status visible?
- Candidate local measure
- Requests without an owner, aged work, transfers, and escalations using locally approved definitions.
Executive guidance · Signal
Partner-route reliability
Do participating teams share one current route and understand who owns each dependency?
- Candidate local measure
- Locally defined conflicting instructions, unaccepted handoffs, unresolved dependencies, repeat contacts, and partner feedback.
Executive guidance · Signal
Improvement closure
Does the organization correct recurring friction and report what changed?
- Candidate local measure
- Selected barriers, assigned actions, completion status, and post-change review.
Figure 4
The operating system behind the dashboard
The four operating signals from this brief’s dashboard, each tied to the candidate owner named in the executive scorecard, around one accountable route. Drawn from the page’s original executive guidance.
Data note. Structural diagram; no measured values.
Limitation. Owners are candidates to be confirmed locally.
Figure data (4 rows)
| Operating signal | Candidate owner |
|---|---|
| Entry-point clarity | Executive sponsor and operational lead |
| Ownership reliability | Operational owner and participating teams |
| Partner-route reliability | Sending and receiving owners |
| Improvement closure | Improvement owner and executive sponsor |
Executive guidance · Handoff workflow
Keep work owned when it crosses a boundary.
A handoff is reliable only when the sending party knows who is expected to receive the work, the receiving party acknowledges responsibility, and any unresolved exception remains visible. Local policy and qualified judgment control the actual process.
How responsibility moves
Lane A
From message to accepted ownership
- Confirm the approved message and intended audience.
- Publish the actual entry point and receiving role.
- Acknowledge receipt using the locally approved method.
- Escalate when ownership or response remains unclear.
Lane B
From accepted ownership to verified follow-through
- Record the next accountable owner and visible status.
- Name the sending and receiving owners, shared information, current status, and unresolved dependency.
- Keep unresolved work visible across boundaries.
- Confirm closure or document the continuing exception.
Executive guidance · Executive scorecard
Ask questions that connect intent, ownership, and results.
The scorecard keeps review focused on decisions. Leaders should set definitions locally, examine variation without overclaiming cause, and pair quantitative signals with the experience of people who use and operate the route.
Who reviews what
- Executive sponsor and operational lead
- Operational owner and participating teams
- Sending and receiving owners
- Improvement owner and executive sponsor
Candidate owners named in the scorecard, confirmed locally.
| Operating signal | Executive question | Candidate owner | Suggested review point |
|---|---|---|---|
| Entry-point clarity | Can people and staff identify the approved first step without searching across conflicting instructions? | Executive sponsor and operational lead | At campaign launch and close |
| Ownership reliability | Does a specific team accept each request and make its status visible? | Operational owner and participating teams | At a locally defined cadence |
| Partner-route reliability | Do participating teams share one current route and understand who owns each dependency? | Sending and receiving owners | At a locally defined cadence |
| Improvement closure | Does the organization correct recurring friction and report what changed? | Improvement owner and executive sponsor | Until action is verified |
Figure 5
Control points for reliable digital self-management support
| Control point | Risk if missing | Owner | Evidence of control |
|---|---|---|---|
| Screening and referral to digital navigation | Patients who need help are never identified | Ambulatory operations leader | Share of patients screened for digital access needs and referred |
| Assisted onboarding for portal and video visits | Devices are provided without the skills to use them | Digital health program director | Task completion after onboarding, by language and age |
| Proxy access offered at registration | Care partners use patient credentials and messages are misattributed | Health information management director | Share of patients with a registered care partner |
| Defined message response standard and routing | Delayed replies erode trust in the portal | Chief medical officer and ambulatory nursing lead | Median response time against the published standard |
| Follow-up when pre-visit tasks are incomplete | Assessments silently fail before visits | Primary care practice managers | Share of incomplete assessments followed up before the visit |
| Usability testing with excluded users | Design barriers are mistaken for patient skill gaps | Chief information officer and vendor manager | Documented usability findings and fixes per release |
| Stratified activation and access reporting | Disparities in digital use remain invisible | Quality and health equity officer | Activation and completion results by age, race, language and connectivity |
Control points derived from the cited evidence [8], [3], [15], [1], [14], [7], [2] and this brief’s executive guidance.
Data note. Each row is a control to verify, not a measured result.
Limitation. Owners and evidence of control must follow local policy and applicable requirements.
Public communication
Communicating in ways that build confidence and choice
Communication is the visible face of patient empowerment. Patients judge a portal by whether its messages are clear, whether replies come on time and whether a person is available when the tool fails. Each of these is a design choice. Patients also judge it by whether the language matches their own. Communication plans should cover the portal, the phone line and the clinic desk together.
Patient-centered communication links digital use to perceived quality. An analysis used national survey data from 2018 to 2020 for adults aged 65 or older.[4] It found a significant indirect effect of health record use on quality of care through patient-centered communication.[4] That indirect effect was 0.12 in the full sample and stronger, at 0.14, among people over 70.[4] The authors called for tailored record design and communication strategies.[4] Communication quality, in other words, is part of how patients experience digital care.
Patients value the portal when it works. In the geriatric practice survey, 79.8% of patients and 81.6% of caregivers felt the portal improved their care.[1] Organizations can protect that goodwill by publishing realistic response times and explaining who will reply. Replies from non-physician staff appeared among the negative themes, so patients notice who answers their messages.[1]
Messages should also invite help-seeking. The homebound older adult study found that assisted training mattered more than devices alone.[3] Public messages that promote a portal should therefore name a phone number, a navigator or a clinic contact that can help someone get started. A message that only says “sign up online” excludes the people least able to do so. Messages should also be available in the languages patients prefer and in formats that work on a basic phone.
Plain language and navigation cues support health literacy directly. The primary care pain program showed the largest gains among later domains in navigating the health care system.[13] Communication that explains where to go next, who owns the next step and how to ask for help reinforces that skill. Clear, consistent messages across the portal, the clinic and community partners make empowerment practical rather than rhetorical. The same discipline applies to after-visit summaries, reminders and result notifications, which are often the first portal content patients see.
Executive guidance · 90-day plan
Move from listening to a verified improvement in 90 days.
The time boxes below are a management framework, not a clinical timeline. Adjust them to risk, scope, governance, resources, stakeholder participation, and applicable review requirements.
Ninety days, three moves
- Days 1–30See the current route
- Days 31–60Build the reliable path
- Days 61–90Make the change visible
Days 1–30 · Listen and map
See the current route
- Name an executive sponsor and an operational owner.
- Listen to people using the route and representative frontline teams.
- Map how Health Empowerment Day communications connect to real entry points, owners, transitions, and escalation.
- Select one recurring barrier that the organization can responsibly address.
Days 31–60 · Design and test
Build the reliable path
- Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal.
- Validate the design with every sending and receiving team involved.
- Test one internal or partner handoff and correct a verified communication, dependency, or ownership gap.
- Test the route in more than one representative setting or operating period where practical.
Days 61–90 · Implement and verify
Make the change visible
- Launch the redesigned route with a small set of locally defined measures.
- Review unresolved work and recurring friction using a learning approach.
- Correct implementation barriers and record who owns each remaining dependency.
- Report what changed, what evidence was reviewed, and what still requires live oversight.
Figure 6
The 90-day plan on one timeline
The 90-day plan from this brief drawn as a timeline: each action sits in the 30-day window the plan assigns it. The full wording of each action is in the figure data and in the plan above.
Data note. Time boxes are a management framework, not a clinical timeline.
Limitation. Durations are uniform 30-day windows; real tasks may span windows.
Figure data (12 rows)
| Window | Action |
|---|---|
| Days 1–30 · Listen and map | Name an executive sponsor and an operational owner. |
| Days 1–30 · Listen and map | Listen to people using the route and representative frontline teams. |
| Days 1–30 · Listen and map | Map how Health Empowerment Day communications connect to real entry points, owners, transitions, and escalation. |
| Days 1–30 · Listen and map | Select one recurring barrier that the organization can responsibly address. |
| Days 31–60 · Design and test | Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal. |
| Days 31–60 · Design and test | Validate the design with every sending and receiving team involved. |
| Days 31–60 · Design and test | Test one internal or partner handoff and correct a verified communication, dependency, or ownership gap. |
| Days 31–60 · Design and test | Test the route in more than one representative setting or operating period where practical. |
| Days 61–90 · Implement and verify | Launch the redesigned route with a small set of locally defined measures. |
| Days 61–90 · Implement and verify | Review unresolved work and recurring friction using a learning approach. |
| Days 61–90 · Implement and verify | Correct implementation barriers and record who owns each remaining dependency. |
| Days 61–90 · Implement and verify | Report what changed, what evidence was reviewed, and what still requires live oversight. |
Executive guidance · Leadership close
Carry one accountable improvement beyond the campaign window.
Recognition matters. It becomes durable when leaders also listen, clarify the route, support the people operating it, close an identified gap, and report the result without claiming more than the evidence supports.
Leadership commitment
Listen to the people closest to the route, assign one barrier, and verify the change.
Executive action kit · Day observance
Turn Health Empowerment Day into accountable action.
Use the observance to review how people find information, enter the right route, and remain connected through follow-through.
Leadership focus
Use this observance to examine trustworthy information, prevention access, and community connection. Select one verified barrier, assign an accountable owner, and carry the improvement beyond the campaign window.
Workforce lens
Ask whether staffing, role clarity, training, tools, workload, and escalation support the people operating the information, access, coordination, and follow-through pathway.
Patient and community lens
Make the approved first step clear. Test whether a person can move from information to an acknowledged next action without navigating conflicting instructions.
Equity and access lens
Review language, disability, transportation, digital access, geography, trust, and other barriers using protected feedback and locally appropriate data.
Five-minute briefing
Inspect the operating sequence
Listen with people using the pathway, frontline teams, operational leaders, and community partners. Find one a message, request, referral, or handoff that does not reach an accountable owner, then test the locally approved route from entry through acknowledged follow-through.
- Listen
- Clarify entry
- Coordinate the partner route
- Protect transitions
- Verify and learn
Leadership actions for this week
- Name an executive sponsor and frontline operating owner.
- Ask people using and operating the pathway where ownership becomes unclear.
- Test one representative route from first question to acknowledged next step.
- Select one barrier that can be corrected without overstating the evidence.
- Set a review date and define how completion will be verified.
Candidate measures
Define every numerator, denominator where relevant, owner, data source, exclusions, cadence, and limitation locally. These are management prompts, not external benchmarks.
- Locally defined contact, routing, and repeat-contact signals by channel and service.
- Requests without an owner, aged work, transfers, and escalations using locally approved definitions.
- Locally defined conflicting instructions, unaccepted handoffs, unresolved dependencies, repeat contacts, and partner feedback.
Department readiness checklist
- The public and staff entry points match the actual approved process.
- A specific role accepts each request, referral, or escalation.
- Handoffs include acknowledgment and a visible unresolved state.
- Language, disability, digital, transportation, and trust barriers receive explicit review.
- Communications do not introduce unsupported themes, statistics, or clinical advice.
- A named leader will review what changed after the observance.
Intended audiences
- Executive and Operational Leaders
- Public Health and Community Partners
Staff communication template
During Health Empowerment Day, our organization will connect awareness with a practical review of the information, access, coordination, and follow-through pathway. Use approved information, identify the correct entry point, confirm ownership when work moves, protect privacy, and escalate unresolved barriers through local channels.
Community communication template
Health Empowerment Day is an opportunity to share trustworthy information and make the next step easier to find. Use our approved channels for information and support. If a request changes hands, our goal is to keep ownership and follow-through visible.
Measurement worksheet
- Signal
- What observable condition will show whether the route works?
- Definition
- What is included, excluded, and counted?
- Owner
- Who reviews the signal and acts on exceptions?
- Cadence
- When will leaders review it?
- Equity check
- Which differences require protected, locally appropriate review?
- Closure
- What evidence will confirm the improvement was completed?
- Editorial review
- Completed
- Source records
- 2 listed under Authoritative resources
- Review standard
- Sourced facts remain separated from original executive guidance
- Clinical boundary
- No new statistical or clinical claim was added by this action kit
Sources and content boundary
Authoritative resources
Use note: All operating models, measures, scorecard questions, and action steps are original executive guidance. This article supports leadership planning and education. It does not replace clinical judgment, emergency procedures, legal advice, professional standards, organizational policy, or applicable federal, state, and local requirements.
Peer-reviewed references
References
Fifteen peer-reviewed sources, newest first. Each was individually verified through authenticated academic research databases. Bracketed numbers in the text link here; the original executive guidance on this page carries no citations because it is guidance, not a sourced claim. Sources last checked in those databases on .
- 1.Rydberg MG, Gilliam MA, Kelley CJ, Lourduraj S, Niznik JD. Patient and Caregiver Expectations for Patient Portal Communication With Providers: Perspectives From an Academic Geriatric Primary Care Practice. Journal of the American Geriatrics Society. 2026. https://doi.org/10.1111/jgs.70620
- 2.Park J, Hou SI. Identifying Factors Associated With Patient Portal and Synchronous Telehealth Use Across Age Groups in the Postpandemic Era: Retrospective Analysis of the Health Information National Trends Survey. JMIR Aging. 2026;9:e83730. https://doi.org/10.2196/83730
- 3.Park J, Kim B, Cho J, Park S. Bridging the Digital Divide: Factors Influencing eHealth Use Among Homebound Older Adults During the COVID-19 Pandemic. Journal of Applied Gerontology. 2026;45(3):550-558. https://doi.org/10.1177/07334648251343407
- 4.Alma Taya D, Hsu HC, Chuang KY, Huang YL, Chiao C, Chang LY, et al. How Patient Use of Electronic Health Records Affects Perceived Quality of Care in Older Adults: Exploring Gender and Age Disparities. Journal of Applied Gerontology. 2026;45(4):767-777. https://doi.org/10.1177/07334648251350733
- 5.Jeong CH, Kim B, Bessette M. Navigating the Digital Divide: Utilization of Patient Portals Among Older Adults During the COVID-19 Pandemic in the United States. Qualitative Health Research. 2026;36(6):565-577. https://doi.org/10.1177/10497323251316194
- 6.Antonioli SS, Alpert Z, Mishra S, Onakomaiya D, Vallurupalli N, Bosco JA, et al. The Impact of Social Drivers of Health on Patient Portal Utilization for Total Joint Arthroplasty Patients: A Qualitative Study. Arthroplasty Today. 2026;37. https://doi.org/10.1016/j.artd.2025.101803
- 7.Rapson T, Ramirez M, He S, Wong J, Kim HC, Luna I, et al. Identifying Skill and Usability Barriers to Digital Health Tool Use Among Older Adult Patients in US Safety Net Clinics: Mixed Methods Study. JMIR Human Factors. 2026;13:e78430. https://doi.org/10.2196/78430
- 8.Natsuhara KH, Shah ND, Ma C, Rahman SB, Dy M, Elkhatib H, et al. Bridging the Digital Divide with Digital Navigation in the California Safety Net: A Mixed-Methods Study. Journal of General Internal Medicine. 2026:1-14. https://doi.org/10.1007/s11606-026-10270-4
- 9.Johnson DJ, Rodriguez TP. Clinician adopter profiles of behavioral mobile health apps: A two-profile typology for integrated primary care implementation. Families, Systems, & Health. 2026. https://doi.org/10.1037/fsh0001065
- 10.Granof M, Ledley K, Xia W, Myrick KJ, Torous J. A pragmatic review of the applicability of existing digital navigator training programs to healthcare settings. Journal of Mental Health. 2026:1-13. https://doi.org/10.1080/09638237.2026.2732871
- 11.Alosta MR, Atiyeh H, Hani SB, Hamdan‐Mansour A, Al‐yyan AA, Afaneh T, et al. Patient Activation and Diabetes Outcomes Among Jordanian Patients With Type 2 Diabetes: Longitudinal Evidence on Adherence and Glycemic Control With Linear Mixed Model Analysis. Research in Nursing & Health. 2026;49(5):564-573. https://doi.org/10.1002/nur.70080
- 12.Alsaad SM, Almalki MF, Alotaibi MA, Alaraik EF, AlSaif HI, Alrasheed AA, et al. Improving Clinical Patient Activation and Strengthening Health Outcomes: Findings from a Quasi-Experimental Study. Journal of Clinical Medicine. 2026;15(1):301. https://doi.org/10.3390/jcm15010301
- 13.Gjesdal K, Skurtveit S, Djuv A, Paulsen A, Rolova G, Sevild C, et al. Changes in health literacy following participation in a multidisciplinary primary care intervention for people with chronic pain: a longitudinal cohort study. Scandinavian Journal of Pain. 2026;26(1). https://doi.org/10.1515/sjpain-2026-0034
- 14.Pack A, Bailey SC, O’Conor R, Velazquez E, Wismer G, Yeh F, et al. A Portal-Based Intervention (PATTERN) Designed to Support Medication Use Among Older Adults: Feasibility and Acceptability Study. JMIR Formative Research. 2025;9:1-8. https://doi.org/10.2196/71676
- 15.Gleason KT, Wu MMJ, Wec A, Powell DS, Zhang T, Gamper MJ, et al. Use of the patient portal among older adults with diagnosed dementia and their care partners. Alzheimer’s & Dementia. 2023;19(12):5663-5671. https://doi.org/10.1002/alz.13354
Claim-to-source matrix
What each source supports
Every sourced claim in the new sections maps to the references that support it, the section where it is used, and the limitation a reader should keep in mind. Original executive guidance carries no sources because it is guidance, not a finding.
| Claim group | Sources | Years | Used in | Limitation |
|---|---|---|---|---|
| National portal and telehealth use by age and race | [2] | 2026 | Current evidence | Cross-sectional survey; self-reported use; coefficients reflect associations, not effects. |
| Digital task skills and usability barriers in safety-net care | [7] | 2026 | Access | Single urban safety-net system; 64 participants; tasks performed in English. |
| Patient activation change with structured or tailored support | [11] [12] | 2026 | Current evidence | Observational and quasi-experimental designs with small samples in single countries; clinical changes not consistent. |
| Health literacy improvement in a primary care program | [13] | 2026 | Current evidence | Single-arm cohort of 43 completers; no control group. |
| Portal task completion and care partner access | [14] [15] | 2025, 2023 | Continuum of care | Single health systems; feasibility study with 64 participants and a cohort limited to diagnosed dementia. |
| Message expectations and perceived value of portals | [1] [4] | 2026 | Public communication | One academic practice with a 20.4% response rate; national survey path analysis is cross-sectional. |
| Devices, training and digital navigation models | [3] [8] | 2026 | Access | Secondary survey data from the pandemic period and a California safety-net sample of 50 participants. |
| Navigator training and clinician adoption | [10] [9] | 2026 | Human infrastructure | Pragmatic review of 9 programs found through general web search; clinician sample of 69 in integrated primary care. |
| Patient-described barriers and trust | [6] [5] | 2026 | Equity and trust | Qualitative interviews in specific populations; findings describe experience, not prevalence. |
About the author
Greg Wahlstrom
MBAHCM
President and Chief Executive Officer, The Healthcare Executive
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