JMIR Publications

ABSTRACT

Background:

In the Netherlands, the health care system and related information technology landscape are fragmented. Recently, hospitals have started to launch patient portals. It is not clear how these portals are used by patients and their health care providers.

Objective:

To explore use, usability and usefulness of a recently introduced patient portal in an academic hospital in order to learn lessons for the implementation of patient portals in a fragmented health care system.

Methods:

A mixed-methods study design was used. In the quantitative study arm characteristics of patients who used the portal were analysed in addition to their utilisation of the portal. In the qualitative study arms, think aloud observations were done among patients who logged in for the first time. Focus group discussions were conducted with patients and health care providers who were familiar with the portal. Thematic content analysis of qualitative data was carried out and overarching themes were identified using a framework analysis.

Results:

One year after the introduction of the portal, 13.5% of all patients who visited the hospital had logged in to the portal. Utilisation of the portal was associated with age, socioeconomic status and number of diagnoses. The portal was mostly used to check lab results and letters that were sent to the general practitioner and less frequently to send a message to their health care provider. Overarching themes that emerged from the qualitative analyses were: (1) usability and user friendliness of the portal, (2) HCP-patient communication through the portal (3) usefulness of the information that can be accessed through the portal, (4) integration of the portal in care and work processes, and (5) HCP and patient roles and relations.

Conclusions:

One year after implementation of the portal, adoption by patients and the perceived usability is promising. Patients and health care providers agree that the portal has the potential to increase patient engagement in their care processes. However, use of the portal is not yet firmly integrated in care practices or in the workflow of HCPs. Both HCPs and patients have uncertainties about how to use the new communication opportunities the portal provides. Clinical Trial: Ethical approval was requested and granted by the Research Ethics Committee of the Radboud University Nijmegen Medical Centre under number 2016-3091.