JMIR Publications

ABSTRACT

Background:

The recent coronavirus (COVID-19) crisis has seriously impacted the capacity of the regular healthcare system. This is reflected in limited access to non-urgent care for chronically ill patients in the Dutch healthcare system. Nevertheless, this patient group depend largely on healthcare assistance to manage their illnesses. Patient portals are used to provide continued healthcare (remotely) during the COVID-19 crisis and potentially after.

Objective:

The objective of this study was to examine predictors of chronically ill patients’ usage and non-usage of patient portals. Among portal users, predictors of patients’ willingness to recommend, and among non-users, predictors of their likelihood of future usage were assessed.

Methods:

An online self-administered questionnaire was distributed among chronically ill patients via social media in May 2020. The questionnaire consisted of four parts: 1) Demographics including age and daily internet hours of usage; 2) Physical Health Status including COVID19 infection and locus of control and Hospital Visits; 3) Mental Health Status including depression and life satisfaction; 4) Portal Usage including response wait time and awareness. Descriptive analyses, correlation, univariate, and multivariate analyses were conducted to identify factors that affect portal usage, users’ willingness to recommend, non-users’ likelihood of future portal usage.

Results:

A total of 652 patients responded of which 461 valid questionnaires were included. Among the 461 patients, 67% (307/461) of them identified as patient portal users. Of the non-users, 55% (85/154) reported not to be aware of the existence of a patient portal at their hospital. Significant predictors of portal usage include locus of control (P=.04), hospital visit time (P=.03), depression scale (P=.03), and status of life satisfaction (P=.02). Among portal users, current waiting time to get a response via the portal (P<.001) and maximum acceptable waiting time (P<.001) are the strongest predictors for willingness to recommend the portal; among non-users, the model predicts that those who were not aware of patient portals (P<.001) and were willing to wait moderately long (P<.001) are most likely to use the portal in the future.

Conclusions:

This study provides insights on factors that influence portal usage and willingness to recommend, based on which healthcare providers can improve the adoption of patient portals as well as their services. The results of this study suggest that healthcare providers should leverage efficient operations management to improve responsiveness and reduce waiting time to improve user satisfaction and willingness to recommend usage. Healthcare organizations need to increase portal awareness among non-users and train their patients to increase both usage and longer adoption of patient portals. Factors including depression and life satisfaction can influence portal usage, therefore future studies on determinates of portal usage and non-usage in this specific population are needed.