Patients’ Perceptions of Portal Use Across Care Settings: Qualitative Study

Abstract

Background Patient portals are a promising instrument to improve patient-centered care, as they provide patients information and tools that can help them better manage their health. The implementation of portals in both the inpatient and outpatient setting gives health care providers an opportunity to support patients both during hospitalization and after discharge. Thus, there is a need to better understand how inpatient and outpatient portals are used across care contexts. Objective This study aimed to examine patients’ perceptions of using inpatient and outpatient portals across the care settings, including how they used the portals and the benefits and concerns associated with portal use. Methods This study was conducted in a large Midwestern academic medical center consisting of seven hospitals. We interviewed 120 patients who had used an inpatient portal during their hospitalization, at 15 days and 6 months postdischarge, to determine their perspectives of portal use in both hospital and outpatient settings. Interview transcripts were analyzed inductively and deductively by using team coding processes consistent with a grounded theory approach. Results Interviews focused on three main areas of portal use: experience with the portal features, perceived benefits, and concerns. Responses at 15 days (n=60) and 6 months (n=60) postdischarge were consistent with respect to perceptions about portal use. Patients identified viewing their health information, managing their schedule, and communicating with providers as notable activities. Convenience, access to information, and better engagement in care were indicated as benefits. Concerns were related to technology issues and privacy/security risks. Conclusions Implementation of inpatient portals as a complement to outpatient portals is increasing and can enable patients to better manage aspects of their care. Although care processes vary substantively across settings, the benefits of convenience, improved access to information, and better engagement in care provide opportunities for portal use across care settings to support patient-centered care.

Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003–2018

“…Our study findings have important implications for clinicians, researchers, and public health practitioners in light of the increased adoption of technologies like personal health record portals [ 45 , 46 ] and the paradigm shift underway in response to the COVID-19 pandemic necessitating and fast-tracking digital health solutions [ 47 ]. Evidence has shown that patient portals can foster patient engagement and improve health outcomes [ 48 – 51 ]. There is growing evidence of a digital divide in portal usage as younger, white cancer patients reportedly showed the heaviest use of patient portals [ 52 ].…”

Facilitating Organizational Change to Accommodate an Inpatient Portal

“…The evidence base for inpatient portals is growing, and recent research suggests that patients provided with an inpatient portal have lower readmission rates and are more likely to search for information online. 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.…”

“…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:…”

“…While we recognize that care team acceptance does not necessarily translate to patient uptake of the technology, our consideration of this issue in the context of organizational change supported our focused analysis. At the same time, given the breadth of this topic, we have conducted other analyses solely focused on patients' perspectives, 15,16 and have noted the importance of developing implementation strategies that accommodate the varied needs of a diverse patient population. [38][39][40] Finally, our study was not designed to assess causality between the three areas of organizational change and the six emergent strategies.…”

Patient Portal Functionalities and Uptake: Systematic Review Protocol

“…For example, patients’ access to the health record with visit notes gives them ability to revisit their notes, which in turn improves their compliance with the care plan set out by the doctor [ 15 , 16 ] and also increases their confidence [ 17 , 18 ]. At the same time, access to the health record or test results gives the patients the chance to instantly and continuously review their record, increasing their knowledge about their condition [ 15 ] and improving their communication with the health care provider through increased ability to discuss their health care condition [ 15 , 16 , 18 ]. Other functionalities of patient portals such as e-messaging or secure messaging and patient education can improve patients’ involvement in their care [ 15 ] and their knowledge about their disease [ 19 ], respectively.…”