Abstract
BackgroundPatient portals offer patients personalized and secure Web access to their medical information and enable patients to manage their health care online. However, there is a lack of information about patient acceptance and use of patient portals among low-income pregnant women.ObjectiveThis formative research aims to assess the potential of a patient portal, MyChart, for improving prenatal health care and pregnancy outcomes, and identify the barriers and facilitators of MyChart use among low-income pregnant women.MethodsA mixed-methods study was conducted with a convenience sample of 18 low-income pregnant women comprising low- and high-risk patients enrolled in a prenatal clinic in eastern North Carolina. MyChart use, patient demographics, and pregnancy information were collected by reviewing electronic medical charts. Health literacy was measured. Reported use and attitudes toward MyChart were collected using a semi-structured interview.ResultsAlthough 39% (7/18) of participants interviewed signed up for MyChart, only 22% (4/18) of them became active users. Another 33% (6/18) had never heard of MyChart or was unsure of how to access it. Users primarily accessed test results and appointment schedules. The main facilitating factors for patient portal use were information and motivation from health care providers and concerns about pregnancy due to a history of miscarriage. Reported barriers were lack of educational resources, lack of care provider encouragement, and technical difficulties possibly exacerbated by low health literacy. Participants also suggested improvements for MyChart, especially the provision of discussion-based support for pregnant women.ConclusionsThe one-time verbal introduction of MyChart does not meet current patients’ needs. Data reveal the need for more consistent patient education and support programs, tailored to patients’ previous pregnancy histories. The clinic also needs to facilitate better provider-patient communication about the importance of MyChart use.
Highlights
Just making a portal available to patients will not ensure that they will use it
Stage 3 requirements may require that you use a patient portal to attest successfully
Patients are likely to use a portal when it is recommended by their providers and has functionality that supports patient activation
Summary
How to Optimize Patient Portals for Patient Engagement and Meet Meaningful Use Requirements. You will have better success meeting meaningful use requirements for stage 2 if you integrate a patient portal effectively in your practice operations. Stage 3 requirements may require that you use a patient portal to attest successfully. The portal must be integrated into clinical encounters so the care team uses it to convey information, communicate with patients, and support self-care and decision-making as indicated. Practices have used their portals to successfully serve a wide range of patients, including those who are older, have lower incomes, or are chronically ill. Portal training and technical support will help patients to make the most of its tools and services
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