Adopting Patient Portals in Hospitals: Qualitative Study.

Pauline Hulter,Christine Leenen-Brinkhuis,Marleen De Mul,Anne Marie Weggelaar-Jansen,Bettine Pluut,Kees Ahaus

doi:10.2196/16921

Abstract

BackgroundTheoretical models help to explain or predict the adoption of electronic health (eHealth) technology and illustrate the complexity of the adoption process. These models provide insights into general factors that influence the use of eHealth technology. However, they do not give hospitals much actionable knowledge on how to facilitate the adoption process.ObjectiveOur study aims to provide insights into patient portal adoption processes among patients and hospital staff, including health care professionals (HCPs), managers, and administrative clerks. Studying the experiences and views of stakeholders answers the following question: How can hospitals encourage patients and HCPs to adopt a patient portal?MethodsWe conducted 22 semistructured individual and group interviews (n=69) in 12 hospitals and four focus groups with members of national and seminational organizations and patient portal suppliers (n=53).ResultsThe effort hospitals put into adopting patient portals can be split into three themes. First, inform patients and HCPs about the portal. This communication strategy has four objectives: users should (1) know about the portal, (2) know how the portal works, (3) know that action on the portal is required, and (4) know where to find help with the portal. Second, embed the patient portal in the daily routine of HCPs and management. This involves three forms of support: (1) hospital policy, (2) management by monitoring the numbers, and (3) a structured implementation strategy that includes all staff of one department. Third, try to adjust the portal to meet patients’ needs to optimize user-friendliness in two ways: (1) use patients’ feedback and (2) focus on optimizing for patients with special needs (eg, low literacy and low digital skills).ConclusionsAsking stakeholders what they have learned from their efforts to stimulate patient portal use in hospitals elicited rich insights into the adoption process. These insights are missing in the theoretical models. Therefore, our findings help to translate the relatively abstract factors one finds in theoretical models to the everyday pragmatics of eHealth projects in hospitals.

Highlights

Electronic health technology is generally considered promising for improving both the well-being and health of patients and the efficiency and effectiveness of the health care organization [1]
Try to adjust the portal to meet patients’ needs to optimize user-friendliness in two ways: (1) use patients’ feedback and (2) focus on optimizing for patients with special needs. Asking stakeholders what they have learned from their efforts to stimulate patient portal use in hospitals elicited rich insights into the adoption process
Our study aims to provide insights into the adoption process of a patient portal by patients and health care professional NASSS (HCP)

Summary

Introduction

Electronic health (eHealth) technology is generally considered promising for improving both the well-being and health of patients and the efficiency and effectiveness of the health care organization [1]. Several studies show that its promise is not always fulfilled [1] and the results on the benefits gained are diverse [1,2] This applies to patient portals [2], which have sparked the interest of researchers, government policy makers, and health care organizations. Theoretical models help to explain or predict the adoption of electronic health (eHealth) technology and illustrate the complexity of the adoption process. These models provide insights into general factors that influence the use of eHealth technology. They do not give hospitals much actionable knowledge on how to facilitate the adoption process

Methods

Results

Discussion

Conclusion