Abstract
BackgroundPatient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear.ObjectiveThe aim of this systematic review was to summarize evidence on the impact of patient portals on health outcomes and health care efficiency, and to examine user characteristics, attitudes, and satisfaction.MethodsWe searched the PubMed and Web of Science databases for articles published from January 1, 2013, to October 31, 2019. Eligible studies were primary studies reporting on the impact of patient portal adoption in relation to health outcomes, health care efficiency, and patient attitudes and satisfaction. We excluded studies where portals were not accessible for patients and pilot studies, with the exception of articles evaluating patient attitudes.ResultsOverall, 3456 records were screened, and 47 articles were included. Among them, 11 studies addressed health outcomes reporting positive results, such as better monitoring of health status, improved patient-doctor interaction, and improved quality of care. Fifteen studies evaluated the impact of digital patient portals on the utilization of health services with mixed results. Patient characteristics were described in 32 studies, and it was reported that the utilization rate usually increases with age and female gender. Finally, 30 studies described attitudes and defined the main barriers (concerns about privacy and data security, and lack of time) and facilitators (access to clinical data and laboratory results) to the use of a portal.ConclusionsEvidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy. It is still unclear whether the use of patient portals improves health service utilization and efficiency.
Highlights
In recent years, electronic tools that allow patients to interact with health care professionals have considerably increased with consequences on the awareness of citizens about their own health [1]
Due to the considerable amount of literature published on the topic of patient portals, the aim of this review was to provide evidence and to gather information systematically
Similar to the review published in 2013 by Goldzweig et al [4], the outcomes were grouped into four aspects, namely, health outcomes and adherence, health care efficiency, patient characteristics, and attitudes and satisfaction, and showed nonunique results in terms of benefits brought by patient portals concerning patient experience and health
Summary
Electronic tools that allow patients to interact with health care professionals have considerably increased with consequences on the awareness of citizens about their own health [1]. Besides guaranteeing protected access to EMRs, more advanced patient portals allow secure message exchange between health professionals and citizens, consultation of educational material adapted to patients’ own characteristics, appointment scheduling, automatic renewal of medical prescriptions for chronic diseases, and facilitation of payments. Despite their potential benefits, several studies have proved underuse or inappropriate use of patient portals and their limited impact [5]. Conclusions: Evidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy It is still unclear whether the use of patient portals improves health service utilization and efficiency
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