Effects of a Web-Based Patient Portal on Patient Satisfaction and Missed Appointment Rates: Survey Study

Graham, Timothy A.D.; Ali, Samina; Avdagovska, Melita; Ballermann, Mark

doi:10.2196/17955

Cited by 54 publications

(67 citation statements)

References 16 publications

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“…In this study, we sought to clarify why portals can, at times, fail to achieve their transformative potential. In parallel with this work, a quantitative survey was conducted on patient views of the portal [ 12 ], and the views of the clinicians and managers presented here complement those findings.…”

Section: Introductionmentioning

confidence: 99%

Patient Portal Implementation and Uptake: Qualitative Comparative Case Study

et al. 2020

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Background Giving patients access to their health information is a provincial and national goal, and it is critical to the delivery of patient-centered care. With this shift, patient portals have become more prevalent. In Alberta, the Alberta Health Services piloted a portal (MyChart). There was a need to identify factors that promoted the use of this portal. Furthermore, it was imperative to understand why there was variability in uptake within the various clinics that participated in the pilot. Objective This study aims to identify potential factors that could improve the uptake of MyChart from the perspectives of both users and nonusers at pilot sites. We focused on factors that promoted the use of MyChart along with related benefits and barriers to its use, with the intention that this information could be incorporated into the plan for its province-wide implementation. Methods A qualitative comparative case study was conducted to determine the feasibility, acceptability, and initial perceptions of users and to identify ways to increase uptake. Semistructured interviews were conducted with 56 participants (27 patients, 21 providers, 4 nonmedical staff, and 4 clinic managers) from 5 clinics. Patients were asked about the impact of MyChart on their health and health care. Providers were asked about the impact on the patient-provider relationship and workflow. Managers were asked about barriers to implementation. The interviews were recorded, transcribed verbatim, and entered into NVivo. A thematic analysis was used to analyze the data. Results Results from a comparison of factors related to uptake of MyChart in 5 clinics (2 clinics with high uptake, 1 with moderate uptake, 1 with low uptake, and 1 with no uptake) are reported. Some theoretical constructs in our study, such as intention to use, perceived value, similarity (novelty) of the technology, and patient health needs, were similar to findings published by other research teams. We also identified some new factors associated with uptake, including satisfaction or dissatisfaction with the current status quo, performance expectancy, facilitating conditions, behavioral intentions, and use behavior. All these factors had an impact on the level of uptake in each setting and created different opportunities for end users. Conclusions There is limited research on factors that influence the uptake of patient portals. We identified some factors that were consistent with those reported by others but also several new factors that were associated with the update of MyChart, a new patient portal, in the clinics we studied. On the basis of our results, we posit that a shared understanding of the technology among patients, clinicians, and managers, along with dissatisfaction with nonportal-based communications, is foundational and must be addressed for patient portals to support improvements in care.

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Section: Introductionmentioning

confidence: 99%

Patient Portal Implementation and Uptake: Qualitative Comparative Case Study

et al. 2020

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“…The following sections summarize the studies according to the QA dimensions ( Multimedia Appendices 3 - 6 ) [ 27 , 43 , 44 , 46 - 48 , 53 , 55 - 58 , 60 - 63 , 65 , 67 , 68 , 72 - 103 , 105 - 114 , 119 , 126 , 127 , 129 ].…”

Section: Resultsmentioning

confidence: 99%

“…The patient perspective was explored in 44 peer-reviewed [ 43 , 44 , 46 - 48 , 53 , 55 , 56 , 58 , 60 - 63 , 65 , 67 , 68 , 72 - 99 ] and 15 gray literature [ 100 - 114 ] studies. Several methods (mixed, n=12; observational, n=5; qualitative, n=5; RCT, n=1; retrospective, n=14; and survey, n=22) were applied to gain insights from patients through surveys, interviews, focus groups, and administrative data.…”

Section: Resultsmentioning

confidence: 99%

Capturing the Impact of Patient Portals Based on the Quadruple Aim and Benefits Evaluation Frameworks: Scoping Review

2020

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Background Despite extensive and continuing research in the area of patient portals, measuring the impact of patient portals remains a convoluted process. Objective This study aims to explore what is known about patient portal evaluations and to provide recommendations for future endeavors. The focus is on mapping the measures used to assess the impact of patient portals on the dimensions of the Quadruple Aim (QA) framework and the Canada Health Infoway’s Benefits Evaluation (BE) framework. Methods A scoping review was conducted using the methodological framework of Arksey and O’Malley. Reporting was guided by the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) extension for scoping reviews. A systematic and comprehensive search was conducted using the Ovid platform, and the following databases were searched: Ovid MEDLINE (R) ALL (including epub ahead of print, in-process, and other nonindexed citations), EMBASE, and PsycINFO. CINAHL on the EBSCO platform and Web of Science were searched for studies published between March 2015 and June 2020. A systematic gray literature search was conducted using the Google search engine. Extracted data were tabulated based on a coding template developed to categorize the literature into themes and areas of interest. Results A total of 96 studies were included for data extraction. The studies were categorized based on the QA dimensions, with strict adherence to the definitions for each dimension. From the patients’ perspective, it was determined that most evaluations focused on benefits and barriers to access, access to test results, medication adherence, condition management, medical notes, and secure messaging. From the population perspective, the evaluations focused on the increase in population outreach, decrease in disparities related to access to care services, and improvement in quality of care. From the health care workforce perspective, the evaluations focused on the impact of patients accessing medical records, impact on workflow, impact of bidirectional secure messaging, and virtual care. From the health system perspective, the evaluations focused on decreases in no-show appointments, impact on office visits and telephone calls, impact on admission and readmission rates and emergency department visits, and impact on health care use. Overall, 77 peer-reviewed studies were mapped on the expanded version of the BE framework. The mapping was performed using subdimensions to create a more precise representation of the areas that are currently explored when studying patient portals. Most of the studies evaluated more than one subdimension. Conclusions The QA and BE frameworks provide guidance in identifying gaps in the current literature by providing a way to show how an impact was assessed. This study highlights the need to appropriately plan how the impact will be assessed and how the findings will be translated into effective adaptations.

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“…Alternatively, one of the included studies in this review suggested that actions related to portal use, such as checking a test result, can increase office visits, while actions, such as repeat prescription ordering during the after-hours period, might reduce hospitalizations [ 34 ]. A recent survey study of a patient portal with access to health care records, test results, e-messaging, and appointment booking reported that patients believed portal use helped them “avoid a clinic visit” [ 39 ]. Few studies in the literature also examined the association between patient portal use and missing medical appointments [ 39 , 40 ], which was not examined in any of the studies included in this review.…”

Section: Discussionmentioning

confidence: 99%

“…A recent survey study of a patient portal with access to health care records, test results, e-messaging, and appointment booking reported that patients believed portal use helped them “avoid a clinic visit” [ 39 ]. Few studies in the literature also examined the association between patient portal use and missing medical appointments [ 39 , 40 ], which was not examined in any of the studies included in this review. The health care utilization outcomes associated with patient portal use may need further investigation as the number of studies examining these associations is limited.…”

Section: Discussionmentioning

confidence: 99%

Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

Alturkistani¹,

Qavi²,

Anyanwu³

et al. 2020

J Med Internet Res

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Background Patient portal use could help improve the care and health outcomes of patients with diabetes owing to functionalities, such as appointment booking, electronic messaging (e-messaging), and repeat prescription ordering, which enable patient-centered care and improve patient self-management of the disease. Objective This review aimed to summarize the evidence regarding patient portal use (portals that are connected to electronic health care records) or patient portal functionality use (eg, appointment booking and e-messaging) and their reported associations with health and health care quality outcomes among adult patients with diabetes. Methods We searched the MEDLINE, Embase, and Scopus databases and reported the review methodology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent reviewers screened titles and abstracts, and two reviewers assessed the full texts of relevant studies and performed data extraction and quality assessments of the included studies. We used the Cochrane Collaboration Risk of Bias Tool and the National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool to assess the risk of bias of the included studies. Data were summarized through narrative synthesis. Results Twelve studies were included in this review. Five studies reported overall patient portal use and its association with diabetes health and health care quality outcomes. Six studies reported e-messaging or email use–associated outcomes, and two studies reported prescription refill–associated outcomes. The reported health outcomes included the associations of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI. Few studies reported health care utilization outcomes such as office visits, emergency department visits, and hospitalizations. A limited number of studies reported overall quality of care for patients with diabetes who used patient portals. Conclusions The included studies mostly reported improved glycemic control outcomes for patients with diabetes who used patient portals. However, limitations of studying the effects of patient portals exist, which do not guarantee whether the outcomes reported are completely the result of patient portal use or if confounding factors exist. Randomized controlled trials and mixed-methods studies could help understand the mechanisms involved in health outcome improvements and patient portal use among patients with diabetes. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141131. International Registered Report Identifier (IRRID) RR2-10.2196/14975

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Effects of a Web-Based Patient Portal on Patient Satisfaction and Missed Appointment Rates: Survey Study

Cited by 54 publications

References 16 publications

Patient Portal Implementation and Uptake: Qualitative Comparative Case Study

Patient Portal Implementation and Uptake: Qualitative Comparative Case Study

Capturing the Impact of Patient Portals Based on the Quadruple Aim and Benefits Evaluation Frameworks: Scoping Review

Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

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