JMIR Publications

ABSTRACT

Background:

Patient portals can facilitate patient engagement in care management. Driven by national efforts over the past decade, patient portals are being implemented by hospitals and clinics nationwide. Continuous evaluation of patient portals and reflection of feedback from end users across care settings are needed to make patient portals more user-centered after the implementation.

Objective:

The aim of this study was to investigate the lived experience of using a patient portal in adult patients recruited from a variety of care settings, focusing on their perceived benefits and difficulties of using the patient portal, and trust and concerns about privacy and security.

Methods:

This qualitative descriptive study was part of a cross-sectional online survey research to examine the comprehensive experience of using a patient portal in adult patients recruited from 20 care settings from hospitals and clinics of a large integrated healthcare system in the mid-Atlantic area of the United States. Those who had used a patient portal offered by the healthcare system in the past 12 months were eligible to participate in the survey. Data collected from 734 patients were subjected to descriptive statistics and a combination of content analysis.

Results:

The majority of the participants were female and non-Hispanic white with the mean age of 53.1 years (SD = 15.34). Content analysis of 1,589 qualitative comments identified 22 themes across four topics: beneficial aspects (6 themes) and difficulties (7 themes) in using the patient portal; trust (5 themes) and concerns (4 themes) about privacy and security of the patient portal. The majority of the participants perceived the patient portal functions as beneficial for communicating with healthcare teams and monitoring health status and care activities. At the same time, about a quarter of them shared difficulties they experienced while using those functions, including not getting eMessage responses timely and difficulty finding information in the portal. Protected login process and trust in healthcare providers were the most mentioned reasons for trusting privacy and security of the patient portal. The most mentioned reason for concerns about privacy and security was the risk of data breaches such as hacking attacks and identity theft.

Conclusions:

This study provides an empirical understanding of the lived experience of using a patient portal in adult patient users across care settings with a focus on the beneficial aspects and difficulties in using the patient portal, and trust and concerns about privacy and security. Our study findings can serve as a valuable reference for healthcare institutions and software companies to implement more user-centered, secure and private patient portals. Future studies may consider targeting other patient portal programs and patients with infrequent or nonuse of patient portals.