More 'vulnerable' patients still not embracing portals

Primary care providers have mixed views on patient portals, and aren't seeing their vulnerable patients using them much, according to a new study in the Journal of Medical Internet Research.

The researchers, from Wake Forest School of Medicine and elsewhere, conducted in-depth interviews with 20 clinical personnel in four North Carolina counties between October 2013 and June 2014. All of the providers served a lower income population.

They found that the main motivator of implementing a patient portal was external pressure, mainly from the Meaningful Use program, which requires more patient engagement. The providers acknowledged the potential benefits of portals, including:

  • Improved office efficiency
  • Fewer phone calls
  • Immediate access to patient electronic requests
  • Easier patient access to information
  • Better patient care management
  • More patient satisfaction
  • Improved information with other providers

However, the researchers also cited a number of problems with portals, including increased stress and impediments to workflows; an inadvertent decrease in the perceived need for office visits; privacy and security breaches; concerns that patients won't fully understand information they're accessing; user error; and the creation of disparities among less technology-savvy, more vulnerable patients.

In addition, they saw few patients using the portals due to lack of knowledge/motivation and their difficultly in using them. Older patients and those without home Internet were less likely to use the portal.

"Uptake of portals was seen as very low, further discouraging providers from embracing them," the researchers said. "Future studies should examine ways portals can be implemented efficiently in practices and strategies for increasing portal usage in vulnerable populations, including older adults. For portals to reach their full potential and meaningfully improve care, clinicians and patients will need to view them as a technology that adds value to care."

Other studies have found that patients have encountered problems using portals. More vulnerable patients also are less likely to use portals, according to some researchers, which can cause disparities and affect healthcare in the future.

To learn more:
- read the study

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