JMIR Publications

ABSTRACT

Background:

Patient portals have been introduced in many countries over the last ten years, but many health information managers still feel they have too little knowledge of patient portals. A taxonomy can help them to better understand, compare, and select patient portals. We therefore developed the TOPCOP taxonomy, the first taxonomy for health information managers for classifying and comparing patient portals. Before the present study, however, the taxonomy had not been evaluated by users.

Objective:

We aimed to improve and evaluate the usefulness of the taxonomy for health information managers to support them in comparing, classifying, defining a requirement profile for, and selecting patient portals offered on the market. Further, we wanted to collect ideas on distinguishing concepts to compare patient portals.

Methods:

We used a modified Delphi approach. We sampled a heterogeneous panel of thirteen health information managers from three countries using the criterion sampling strategy. Four anonymous survey rounds with qualitative and quantitative questions were conducted online. In round one, the panelists assessed the appropriateness of each dimension and we collected new ideas to improve the dimensions. In rounds two and three, the panelists iteratively evaluated the taxonomy that was revised based on round one. In round four, the panelists assessed the need for a taxonomy and the appropriateness of patient engagement as a distinguishing concept. Then they compared two real portals with the final taxonomy and evaluated its usefulness as a whole for comparing patient portals, creating an initial requirement profile, and selecting patient portals offered on the market. To determine group consensus, we applied the RAND/UCLA Appropriateness Method with consensus determined by a median of 7 to 9 without disagreement.

Results:

The revised TOPCOP taxonomy consists of 25 dimensions with 65 characteristics. Consensus was achieved on the need of having such a taxonomy to compare patient portals (median 8), on patient engagement as an appropriate distinguishing concept (median 8), and on the comprehensibility of the taxonomy’s form (median 8). Further, consensus was achieved on the taxonomy’s usefulness for classifying (median 8) and comparing patient portals (median 8), assisting users in better understanding patient portals (median 7), creating a requirement profile, and selecting patient portals (median 8). All medians were achieved without disagreement. As alternative distinguishing concepts, the panelists proposed “Health Literacy”, “Improvement of Health Outcomes”, “System Architecture, Data Types, and Interoperability”, and “Improvement of Work Efficiency and Cost Savings”. By modifying the classic Delphi technique, we created to the best of our knowledge a new Delphi approach in health informatics for evaluating a taxonomy. We call it the Taxonomy-Evaluation-Delphi approach (TED).

Conclusions:

In various countries, health information managers are still having difficulties understanding the multiple application areas and scopes of patient portals. We were able to demonstrate the need for and usefulness of a taxonomy of patient portals from the intended users’ point of view. By having the taxonomy evaluated by health information managers, it was possible to improve the quality and usefulness of the taxonomy and so better meet the health information managers’ needs.