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Patient Portal Adoption Still Slow Despite Proven Benefits

Research shows that due to major patient portal adoption barriers, widespread incorporation of the technology is not soon on the horizon.

By Sara Heath

- While repeated studies indicate that use of the patient portal improves chronic disease management, patient engagement, and overall health, adoption rates still lag.

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In an effort to understand that phenomenon, a research team led by Alexander G. Fiks, MD, MSCE, conducted a study measuring both the effectiveness of a patient portal in improving the health of chronically ill pediatric patients, as well as identify some of the barriers for portal adoption.

The research team began by offering a patient portal, called MyAsthma, to parents and pediatric patients managing asthma. The portal facilitated communication between patients and providers in order to adjust treatment plans to improve overall wellness. It also included patient surveys to collect patient-generated health data.

What Fiks and colleagues found was that very few parents or patients tended to adopt the patient portal.

The trial involved 9,133 eligible participants across 11 states, and yet only 237, or 2.59 percent, of families actually adopted the portal and completed one or more surveys.

Low adoption levels may have been a result of a perceived high level of health, the research team posited. Prior to the start of the study, 93.42 percent of patients were on an asthma controller medication.

Because the children were already working with a physician on a treatment and management plan, perhaps parents perceived their condition as well-managed and did not think they needed the help of a patient portal.

Poor practice workflow and infrastructure also may have led to low portal adoption. If a practice does not have the protocol for managing patient messages or communication over digital devices, patients may be less inclined to adopt those devices.

“Adoption may also have been limited by practices’ infrastructure and workflow for managing electronic receipt of patient-reported information,” Fiks and colleagues explained. “In our qualitative study, both clinicians and families highlighted the importance of coordinated and responsive workflows to implementation success. Workflow issues have been described previously as a challenge to portal implementation and a reason for variability in adoption between practices.”

Despite the low portal adoption rates, the research team said this study still proved the value of patient portal adoption.

For those children with uncontrolled asthma, portal adoption led to asthma medication prescription and more changes and refills of treatment during physician visits.

And as healthcare professionals and patients alike continue to see the benefits of patient portals, they will be more likely to adopt portals and advocate for them during office visits.

“The value to parents, practices, and the health system of implementing portals depends on their ability to improve communication and, ultimately, outcomes,” the research team said. “Although adoption of the portal was low, portal use was associated with increased family and practice engagement in asthma management.”

However, despite the fact that the study showed the value of patient portals through their effectiveness, the researchers say widespread portal adoption will not happen in the short term. This is because of the numerous adoption barriers identified in the study.

“Results of this multisite implementation study suggest that achieving high levels of portal adoption is unlikely in the short term,” Fiks and colleagues concluded. “Many practices will require redesigned and coordinated workflows and will need to develop targeted outreach to families of children with poor asthma control to ultimately support the use of this technology.”

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