Improving Acceptance of Inpatient Portals: Patients' and Care Team Members' Perspectives

Abstract

Background: Inpatient portals are gaining interest as a means to increase patient-centered care during hospitalization. However, acceptance of a new technology such as the inpatient portal relies on perceptions of both its usefulness and ease of use. These factors have not been studied in the context of inpatient portal implementation. Methods: We interviewed patients (n = 123) and care team members (n = 447) about their experiences using an inpatient portal that had been implemented across a large, academic medical center. Interviews lasted 5-15 min, were audiorecorded, transcribed verbatim, and then analyzed using a combination of deductive and inductive methods. Results: Collectively, interviewees reported that the inpatient portal was a useful tool as it improved patients' access to information, enhanced communication, facilitated education, and appeared to promote patients' sense of control while in the hospital. Most interviewees also found the technology easy to use. However, there were concerns that the portal was not easy to use for those less experienced with technology. Interviewees identified the need to emphasize the value of the technology to both patients and care team members and the need to provide additional training to support portal use, as ways to promote acceptance of the tool. Discussion and Conclusions: Inpatient portals can improve patient-centered care, but such improvements require acceptance of the tool by both patients and care team members. Our findings about the usefulness and ease of use of an in-patient portal can inform future efforts to improve the implementation and acceptance of this new technology.

Care Team Perspectives About an Inpatient Portal: Benefits and Challenges of Patients’ Portal Use During Hospitalization

“…Notably, the collaborative features of this HIT tool were perceived to be associated with important benefits such as the ability of the portal to improve communication between patients and care team members. Care team members’ comments appeared consistent with recently reported patients’ perspectives about the inpatient portal’s ability to support communication (McAlearney, Fareed, et al., 2019; McAlearney, Gaughan, et al., 2019; McAlearney, Sieck, et al., 2019). However, we also found that care team members indicated that their use of secure messaging, a feature specifically oriented toward collaborative work, was rare, and that the feature itself was not well understood.…”

“…While the study of inpatient portals is increasing, most research has focused on the patient side of the implementation, investigating tool usability (Britto et al., 2009; Dykes et al., 2014; Greysen et al., 2016), use rates for specific portal features (Aljabri et al., 2018; Dalal et al., 2016; Davis et al., 2015; Fareed et al., 2018; Huerta et al., 2019; Kelly et al., 2017; Robinson et al., 2017; Winstanley et al., 2017), patient activation (Masterson Creber et al., 2018), and patient satisfaction (Britto et al., 2009; Dykes et al., 2014; Greysen et al., 2016; Kelly et al., 2017; Lee et al., 2017; Winstanley et al., 2017). However, inpatient portal implementation also affects the inpatient health care team (Hefner et al., 2018; Masterson Creber et al., 2018; McAlearney, Gaughan, et al., 2019). Inpatient portals require collaboration between the care team and patients as hospital staff must teach patients how to use portal features, answer questions about health information available through the portal, and respond to electronic messages.…”

Patient Portals: Useful for Whom and for What? A Cross-Sectional Analysis of National Survey Data

“…Given that previous research has found that nonuse of patient portal functions has been associated with lack of awareness of the functions, 34,36 increasing awareness of and training around the available functions might impact perceptions of patient portal usefulness. 43,44 Overall, our findings also emphasize the need to consider patients' context of use when examining the suitability of patient portals for different patient populations. 42,45 We found that the nature of the tasks patients perform when using a patient portal varies depending on how frequently they use their patient portals.…”

Facilitating Organizational Change to Accommodate an Inpatient Portal

“…6,7 While these outcomes are promising, other researchers have focused attention on upstream factors that contribute to the success of inpatient portals, such as their use 6,[8][9][10] and usability, [11][12][13][14] the patient's experience of the portal, [15][16][17][18] and the care team's expectations of and experience with the portal. [19][20][21][22] This evidence provides insight into the nuanced ways in which different stakeholders interact with the technology. Importantly, the growing evidence regarding inpatient portals highlights the collaborative aspects of the technology between the patient and the care team with both optimistic potential and cautious pragmatism.…”

“…This introduction process included describing each of the different features of the portal and how the portal and its features can help the patient during their hospital stay. 16,19 Use of this new introduction and additional messaging about the portal worked to not only convince patients about the benefits of using the inpatient portal but also to increase care team buyin. One nurse explained:…”