Patient and Provider Attitudes Toward the Use of Patient Portals for the Management of Chronic Disease: A Systematic Review

Abstract

BackgroundPatient portals provide patients with the tools to better manage and understand their health status. However, widespread adoption of patient portals faces resistance from patients and providers for a number of reasons, and there is limited evidence evaluating the characteristics of patient portals that received positive remarks from patients and providers.ObjectiveThe objectives of this systematic review are to identify the shared characteristics of portals that receive favorable responses from patients and providers and to identify the elements that patients and providers believe need improvement.MethodsThe authors conducted a systematic search of the CINAHL and PubMed databases to gather data about the use of patient portals in the management of chronic disease. Two reviewers analyzed the articles collected in the search process in order remove irrelevant articles. The authors selected 27 articles to use in the literature review.ResultsResults of this systematic review conclude that patient portals show significant improvements in patient self-management of chronic disease and improve the quality of care provided by providers. The most prevalent positive attribute was patient-provider communication, which appeared in 10 of 27 articles (37%). This was noted by both patients and providers. The most prevalent negative perceptions are security (concerns) and user-friendliness, both of which occurred in 11 of 27 articles (41%). The user-friendliness quality was a concern for patients and providers who are not familiar with advanced technology and therefore find it difficult to navigate the patient portal. The high cost of installation and maintenance of a portal system, not surprisingly, deters some providers from implementing such technology into their practice, but this was only mentioned in 3 of the 27 articles (11%). It is possible that the incentives for meaningful use assuage the barrier of cost.ConclusionsThis systematic review revealed mixed attitudes from patients and their providers regarding the use of patient portals to manage their chronic disease. The authors suggest that a standard patient portal design providing patients with the resources to understand and manage their chronic conditions will promote the adoption of patient portals in health care organizations.

Implications of social media use on health information technology engagement: Data from HINTS 4 cycle 3

“…However, despite the healthcare system's progression in creating an environment to increase meaningful use among patients, there are barriers to consumer/patient engagement. Reasons for consumer reticence have included security/privacy concerns, difficulty navigating the HIT platform [24,25], and beliefs that HIT adoption will cause healthcare management to be more difficult [26]. Patients' slow engagement of HIT stands in contrast to reports of continued, robust use of general search engines for health information seeking [27] and to the use of social media sites for seeking informal help on diagnosed conditions [28].…”

Designing a portal to patient-centered care? Let�s start with the patient. A cross-sectional survey. (Preprint)

“…[31], the understanding of their own health [13], the sense of control over their healthcare [32] and the overall quality of their healthcare. [4] In literature there is some skepticism about the influence of a Patient Portal on the security and privacy of health data and the total costs of healthcare. [12,33,34] People are mostly interested in test results, the medication schemes, immunization records and a history of medical visits and procedures.…”

“…[4] In addition to this, EPHR has a positive influence on healthcare utilization. [5] An EPHR can be defined as: ''An electronic application through which individuals can access, manage and share their health information, and that of others for whom they are authorized, in a private, secure, and confidential environment.''…”

“…[9][10][11] Known barriers to the use of portals for patients and providers include security and privacy issues, the negative impact on the workflow and limited user friendliness. [4,12] Benefits associated with the use of a Patient Portal are increased convenience and satisfaction for the patients. [13,14] Patient safety could be improved through identifying errors in medication lists.…”

Preferences for Health Information Technologies Among US Adults: Analysis of the Health Information National Trends Survey (Preprint)

“…[1] More than half of the adults in the U.S. have at least one chronic condition (e.g., hypertension, coronary heart disease, stroke, diabetes, and cancer). [2,3]Cardiovascular disease (CVD) and diabetes are two common chronic conditions that share common risk factors including: age, genetic factors, obesity, poor nutrition, impaired glucose tolerance and physical inactivity. [4] Death from CVD rose by over 40% between 1990 and 2013 as a result of factors such as population increase, aging and epidemiologic changes in chronic disease.…”