JMIR Publications

ABSTRACT

Background:

Giving patients access to their health information is a provincial and national goal and critical to the delivery of patient centered care. With this shift, patient portals have become more prevalent. In Alberta, Alberta Health Services piloted a portal (MyChart). There was a need to identify factors that promoted use of this portal. Furthermore, it was imperative to understand why there was a variability in uptake within the various clinics that participated in the pilot.

Objective:

The aim of this study was to identify potential factors that could improve the uptake of MyChart, from the perspectives of both users and non-users at the 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 prior to province-wide deployment. Semi-structured interviews were conducted with 56 participants (27 patients, 21 providers, 4 non-medical staff, and 4 clinic managers) from 5 clinics. Patients were asked about the impact of MyChart on their health and health care. Providers were questioned 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:

Overall, we identified enablers and barriers combined across all groups. The enablers focused on having access to medical information, being informed, direct communication, ease of usage, and workflow. The barriers were lack of training and education, culture change, and lack of policies and procedures for usage. Similarities were noted between all the groups. Many enablers were barriers as well. Patients stated that MyChart has had a positive impact on their care and they would not want to see this system removed. Providers understood the importance, but stated that not all patients would benefit and it was an add-on to their workflow. For managers, it was about efficiency, innovation, and providing new ways for patients to manage complex chronic conditions.

Conclusions:

The findings build on the identified need around understanding if there is a link between patient portal implementation and patient portal adoptions. Our study demonstrated a direct correlation between implementation, enrollment, and adoption. Furthermore, the enablers and barriers will be essential to policy development regarding patient portals.