JMIR Publications

ABSTRACT

Background:

Patients play a critical role in managing their own health, especially in the context of chronic conditions like diabetes. Electronic patient portals have been identified as a potential means to improve patient engagement, that is, patients’ involvement in their own care. However, little is known about the pathways through which portals may help patients engage in their own care.

Objective:

To understand how an electronic patient portal facilitates patient engagement among individuals with diabetes.

Methods:

This qualitative study employed semi-structured telephone interviews with forty patients living with diabetes since at least 2011, who had experienced uncontrolled diabetes and had used secure messaging through a portal at least four times over an 18-month period. The interviews were recorded, transcribed, coded and analyzed using inductive and deductive approaches to identify how patients use an online health portal.

Results:

Overall, patients who used the portal reported feeling engaged in their health care. We identified four ways in which the portal facilitates patients’ engagement and some challenges. The portal provides a platform that patients use to: 1) better understand their health by asking questions about new symptoms, notes, or labs; 2) prepare for medical appointments by reviewing labs and notes; 3) coordinate care with the health care team within and across facilities; and 4) facilitate communication from patients to providers to request help with their care plan between visits. Several patients reported the portal helped improve the patient-provider relationship, however aspects of portal design may hinder engagement for others. Benefits of the portal for patient engagement were described by many types of patients including individuals in urban and rural settings, with and without mental health conditions, and with varying degrees of diabetes control.

Conclusions:

Patient portals support patient engagement by enabling communication about and coordination of care. Portals can help a wide range of patients engage with their care. Clinical Trial: ClinicalTrials.gov Identifier: NCT02953262