In pursuit of integrated care: the contribution of patient portals (Preprint)

Abstract

Background: Advocates of patient portals claim that they can strengthen integrated care for patients with complex or chronic health issues. However, it remains unclear how patient portals can achieve this, since indicators of integrated care are absent in most research on the matter. Objective: This study investigates the claim that patient portals can strengthen integrated care by reviewing the current research with Minkman's model of integrated care. Methods: A systematic search of PubMed, PsycInfo and Embase was conducted on research literature about patient portals (and related search terms) that was published between 2006 and 2016. Parts of the selected texts were scored on items which contribute to or hinder clusters of the Minkman model, or were absent from the model. Results:The 22 selected studies we analyzed with the Minkman model implicitly address several clusters of integrated care. Most prevalent were patientcenteredness (55 mentions), delivery system (49 mentions) and performance management (33 mentions); the least prevalent were interprofessional teamwork (3 mentions) and commitment (2 mentions). Five studies showed ways in which portals can hinder integrated care (12 mentions), while four studies showed ways in which they can promote integrated care that is not yet present in Minkman's model. Conclusions: Since the majority of the studies described items that contribute towards clusters of the Minkman model, the claim that patient portals can strengthen integrated care appears to have some merit. Items with negative impact are few and are primarily related to the implementation of portals for users. Based on our findings, we advocate using all the clusters of the Minkman model, since it can help patient portals be designed and implemented more effectively.