Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 23, 2020
Date Accepted: Mar 23, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Early assessment of the effects of a web-based patient portal on patient satisfaction and health system usage: a mixed methods study
ABSTRACT
Background:
While Electronic Medical Record (EMR)-tethered patient portals (PPs) are common in other countries, they are still emerging in Canada. We report user satisfaction and effects on medical appointment attendance in a Canadian cohort of patients using a PP within our publicly funded healthcare system.
Objective:
The objectives of our study were to examine the effects of this tethered PP on patient satisfaction and health system usage.
Methods:
Two surveys were deployed, via email, at 2 weeks and 6 months following the first recorded PP access. Database audits of visit attendance were used to supplement and cross reference survey data.
Results:
Between January 2016 and July 2018, 4296 patients accessed the PP. During the study, 28% (957/3421) consented PP users responded to one or more semi-structured electronic surveys. Of respondents, 93% (891/957) reported that the PP was easy to use, 51% (492/975) reported it saved time when scheduling an appointment, and 40% (382/957) reported that they had to repeat themselves less during appointments. Respondents reported PP-related changes in health system use, with 48% (462/957) reporting avoiding a clinic visit and 2.7% (26/957) avoiding an Emergency Department visit. Across 19968 visits in clinics where the PP was introduced, missed appointments were recorded in 9.5% (858/9,021) of non-PP user visits, compared with 4.5% (493/9021) for PP users, representing a 53% relative reduction in no-show rates.
Conclusions:
Early experience with an EMR-tethered PP shows strong reports of positive patient experience, a self-reported decrease in health system use, and a measured decrease in missed appointment rates. Implications on the expanded use of PPs requires more quantitative and qualitative study in Canada
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