Identifying How Patient Portals Impact Communication in Oncology

Abstract

Patient portals are becoming widespread throughout health-care systems. Initial research has demonstrated that they positively impact patient-provider communication and patients' health knowledge, but little is known about the impact of patient portals in the cancer setting, where highly complex and uncertain medical data are available for patients to view. To better understand communicative behaviors and perceptions of the patient portal and how it is utilized in oncology, in-depth, semi-structured interviews were conducted with 48 participants: 35 patients and 13 oncologists. Thematic analysis identified that portals help to enhance participation during in-person consultations, increase patients' self-advocacy, and build rapport with providers. However, patients' comfort level with reviewing information via the portal depended upon the severity of the test. Oncologists worried about patient anxiety and widening health disparities, but acknowledged that the portal can motivate them to expedite communication about laboratory and scan results. As patient portals become more widely used in all medical settings, oncologists should become more engaged with how patients are viewing their medical information and consider the portal within the framework of patient-centered care by valuing patients' communication preferences.

Health Care Professionals’ Experiences of Patient-Professional Communication Over Patient Portals: Systematic Review of Qualitative Studies

“…Experiences related to health care professionals’ work were divided into 5 subthemes, which related to the increased workload [ 39 , 41 , 42 , 44 - 48 , 50 ], more efficient work [ 42 , 44 , 47 , 48 , 50 , 51 ], experiences of fear and discomfort [ 41 , 43 , 46 , 49 , 50 ], increased awareness of patients’ situations [ 41 , 43 , 48 ], and lack of time and expertise required for portal communication [ 42 , 43 , 50 ].…”

“…The health care professionals in the studies were concerned about the patient-professional communication increasing their workload [ 41 , 42 , 44 , 46 , 48 , 50 ]. Although they saw patient participation as a positive outcome of portal communication, having greater patient participation increased the workload [ 41 ].…”

“…The health care professionals in the studies were concerned about the patient-professional communication increasing their workload [ 41 , 42 , 44 , 46 , 48 , 50 ]. Although they saw patient participation as a positive outcome of portal communication, having greater patient participation increased the workload [ 41 ]. Sometimes health care professionals received messages from patients who did not actually need their help [ 46 ], and some of the patients overwhelmed the health care professionals by inappropriately sending them repeated messages [ 47 ].…”

A Review of Web Portal Use by Oncology Patients

“…To obtain a better understanding of communicative behaviors and perceptions of a patient web portal and how it is utilized in oncology, Alpert et al 12 conducted in-depth, semi-structured interviews of 35 cancer patients and 13 oncologists. Content analysis suggested that portals help to enhance participation during in-person consultations, increase patients’ self-advocacy, and build rapport with providers.…”

“…Despite the obvious benefits of online portal use, two of the studies found disadvantages of the internet-based technology, and these included patient anxiety, patients not understanding their results, and patients learning results prior to disclosure by their care teams 12, 13 . All of these disadvantages revolve around patient anxiety, as patients not understanding their results and learning them prior to disclosure by their care teams can both lead to patient anxiety by leaving the patients in limbo for a certain length of time.…”