JMIR Publications

ABSTRACT

Background:

Electronic Health Records (EHR) patient portals are designed to provide medical health records to patients. Using EHR portal is expected to contribute to positive health outcomes as well as facilitating patient-provider communication.

Objective:

Our objective was to examine how portal users report using their portals as well as factors associated with obtaining health information online. We also examined what features were desired by users, how portal users accessed health information online, and impact users’ trust in their patient portal.

Methods:

An online survey study was conducted using Amazon Mechanical Turk. All the participants were adults in the US who used patient portals. The survey included questions asking how the participants used their portals, what factors acted as barriers to using their portals, and how they used and trusted other online health information source as well as their portals. A logistic regression model was used to examine what factors influenced a participant’s trust in their portals. Additionally, desired features and design characteristics were evaluated to support the design of future portals.

Results:

There were 394 participants who completed the survey. The majority of the participants were less than 35 years old (53.8%), with 36.3% between 35 and 55 years old and 9.9% were over 55 years-old. Women accounted for 48.5% of the survey participants. More than 78% of the participants reported using portals at least monthly. The most common portal features used included those related to viewing lab results, making appointments, and paying bills. Participants reported barriers to portal use including data security and limited access to the internet. The results of a logistic regression model used to predict the trust in their portal suggests that those who were comfortable using their portal (Odd Ratio (OR) 7.97, 95% CI 1.11 to 57.32), thought their portal was easy to use (OR 7.4, 95% CI 1.12 to 48.84), and were frequent internet users (OR 43.72, 95% CI 1.83 to 1046.43) were more likely to trust their portal. Those who reported that the portals were important in managing their health (OR 28.13, 95% CI 5.31 to 148.85) and those who reported their portal was a valuable part in their health care (OR 6.75, 95% CI 1.51 to 30.11) were also more likely to trust their portal.

Conclusions:

This study provided insights into the use of portals by internet users, including the desired features of portals, what factors impact users’ trust on portals and barriers in using portals. Designing usable portals may be the most effective approach to improve trust in the portals themselves. The features and usability design of portals are critical factor that contribute to users trust on portals.