JMIR Publications

ABSTRACT

Background:

Web-based outpatient portals help patients engage in the management of their health by allowing them to access their medical information, schedule appointments, track their medications and communicate with their physicians and care team members. Initial studies have shown that portal adoption positively affects health outcomes, but early studies typically relied on survey data. Using data from health portal applications, we conducted systematic assessments of patients’ use of an outpatient portal to examine how patients engage with the tool.

Objective:

We aimed to document the functionality of an outpatient portal in the context of outpatient care by mining portal usage data, and to provide insights into how patients use this tool.

Methods:

Using audit log files from the outpatient portal associated with the electronic health record (EHR) implemented at a large, multi-hospital academic medical center, we investigated the behavioral traces of a study population of 2,607 patients who used the portal between July 2015 and February 2019. Patient portal use was defined as having an active account and having accessed any portal function more than once during the study timeframe.

Results:

Through our analysis of audit logfile data of the number and type of user interactions, we developed a taxonomy of functions and actions, and computed analytic metrics including frequency and comprehensiveness of use. We additionally documented the computational steps required to diagnose artifactual data and arrive at valid usage metrics.

Conclusions:

In discussing the full methodological choices made in our analysis, we hope to promote the replicability of our study at other institutions and contribute to the establishment of best practices that can facilitate the adoption of behavioral metrics that enable measurement of patient engagement based on outpatient portal use.