Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences
Health Information Technology | Health Services Administration
BACKGROUND: Health care organizations are increasingly offering patients access to their electronic medical record and the ability to communicate with their providers through Web-based patient portals, thus playing a prominent role within the patient-centered medical home (PCMH). However, despite enthusiasm, adoption remains low.
OBJECTIVE: We examined factors in the PCMH context that may affect efforts to improve enrollment in a patient portal.
METHODS: Using a sociotechnical approach, we conducted qualitative, semistructured interviews with patients and providers from 3 primary care clinics and with national leaders from across a large integrated health care system.
RESULTS: We gathered perspectives and analyzed data from 4 patient focus groups and one-on-one interviews with 1 provider from each of 3 primary care clinics and 10 program leaders. We found that leaders were focused on marketing in primary care, whereas patients and providers were often already aware of the portal. In contrast, both patients and providers cited administrative and logistical barriers impeding enrollment. Further, although leadership saw the PCMH as the logical place to focus enrollment efforts, providers and patients were more circumspect and expressed concern about how the patient portal would affect their practice and experience of care. Further, some providers expressed ambivalence about patients using the portal. Despite absence of consensus on how and where to encourage portal adoption, there was wide agreement that promoting enrollment was a worthwhile goal.
CONCLUSIONS: Patients, clinicians, and national leaders agreed that efforts were needed to increase enrollment in the patient portal. Opinions diverged regarding the suitability of the PCMH and, specifically, the primary care clinic for promoting patient portal enrollment. Policymakers should consider diverse stakeholder perspectives in advance of interventions to increase technology adoption.
enrollment, patient-centered medical home, personal health record, portal, primary care, qualitative
Rights and Permissions
© Gemmae M Fix, Timothy P Hogan, Daniel J Amante, D Keith McInnes, Kim M Nazi, Steven R Simon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
DOI of Published Version
J Med Internet Res. 2016 Nov 22;18(11):e308. Link to article on publisher's site
Journal of medical Internet research
Fix, Gemmae M.; Hogan, Timothy P.; Amante, Daniel J.; McInnes, D. Keith; Nazi, Kim M.; and Simon, Steven R., "Encouraging Patient Portal Use in the Patient-Centered Medical Home: Three Stakeholder Perspectives" (2016). Open Access Articles. 2986.