- The perceived effectiveness of patient portals in driving parent caregiver engagement in pediatrics is currently limited, presenting more opportunities for healthcare organizations to refine and streamline their patient portal adoption strategies, according to research published in the Journal of Medical Internet Research.
Patient portals are some of the most widely agreed upon patient engagement strategies, the Canadian research team said. Patient portals effectively connect patients with their own health information as well as to their providers via secure messaging. These benefits can extend to the pediatric patient population, although parent caregivers add some complications.
“In pediatric rehabilitation, the chronic nature of children’s difficulties and the need for parental support have resulted in widespread adoption of family-centered care, which stresses the importance of engaging in partnerships with care providers and exchanging information,” the researchers said.
“Through electronic access to health records and e-messaging (secure 2-way messaging), clients and families may feel a greater personal connection to care and partnership in the care process,” the team continued.
Through a 14-month study, the researchers found that patient portals have the potential to drive this level of engagement, but it will take time to perfect the patient portal adoption process.
The researchers introduced 18 parent caregivers and five pediatric clinicians to the patient portal between January 2015 and March 2016. The research team conducted caregiver surveys two months into patient portal use and two months after that as well. These surveys assessed caregiver perceptions of the utility of and satisfaction with the patient portal and secure messaging functions.
The team also conducted individual and focus group interviews with both parent caregivers and clinicians at the same two-month intervals to collect qualitative data.
Patient portal use patterns varied throughout the study. On average, parent caregivers used the portal about 2.5 times monthly, which is higher than the national average. Higher patient portal adoption and use may be due to family involvement in portal development at this hospital, stronger efforts in patient portal marketing, and increased parental concern with their child’s health.
The parent caregiver surveys revealed moderate patient portal utility and satisfaction, as well as a low but emerging impact on caregiver engagement. Qualitative caregiver and clinician interviews corroborated these findings, with both parties questioning how effective patient portal technology was in driving patient engagement.
Despite these limited findings, parent caregivers did report that patient portals helped familiarize them with clinical terms, enriching in-person caregiver-provider communications.
“Several caregivers indicated that reading available reports increased their understanding of the related technical language, and felt this enhanced their ability to engage in conversations about care with service providers,” the research team reported.
Modest patient portal utility, satisfaction, and engagement rates may be due to the length of the study, the researchers posed. It usually takes time for patient engagement technologies to have a remarkable effect on care, and the patterns revealed in this study reflect that.
For example, caregivers initially were most focused on using the patient portal to look at patient medical records. However, as time went on, caregivers shifted their focus to secure messaging and medical lab reports. These patterns likely occurred because more content began to fill these spaces throughout the course of study, the researchers said.
Additionally, the researchers said the limited increase in qualitative patient engagement reports might be because parent caregivers are already highly engaged in a pediatric patient’s care. There may not have been much room for improvement in this area.
Looking to the future for patient portals, both parent caregivers and pediatric clinicians did agree on a few themes. Patient portal uptake will increase through technical improvements, both parties stated, and there is great value in allowing access to medical records and lab results.
However, other qualitative data revealed some departures in priorities for both parent caregivers and clinicians.
“The major difference between caregivers and providers was that caregivers focused on the scope of adoption of the portal system in the organization and expressed their hopes for the future of the portal with respect to their family’s life journey (the scope of adoption and future vision theme), whereas service providers were concerned about how to best manage their investment of time and effort (the use, effort, and investment in the portal theme),” the research team said.
Parent care givers also recognized that time will amplify the positive patient portal effects.
“As well as full organization-wide adoption of the portal system, caregivers’ hopes for the future included greater personalization and comprehensiveness of the provided information,” the research team explained. “As recognized by caregivers, portals are in their infancy and the maturity of portals does not appear to be where it needs to be to improve quality of care and involve the patient in care decisions.”
These results highlight that like most technological innovations, patient portals need time for users to fully experience the tool’s benefits. Patient portal developers can better tailor the tool for optimal results by receiving feedback from users.
“The findings endorse the often-made statement that changing organizational culture takes time,” the research team concluded. “Portal adoption is a process—not a one-time event—and requires a feedback loop (as provided by this study), allowing an organization to improve portal adoption through attention to the needs of the people who use it.”