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Patient Portal, Secure Messaging User Opinions Evolving

Experience patient portal users have changed their views of secure messaging since adopting the tool, but still need some guidance on how to leverage it.

Experience patient portal users need more direction in secure messaging best practices.

Source: Thinkstock

By Sara Heath

- Even seasoned patient portal users need more direction using various tool functions, primarily secure messaging, according to a recent study published in the Journal of Medical Internet Research.

The researchers set out to determine how experienced patient portal users perceive that technology. Although healthcare professionals and hospital leaders are concerned with both patient and provider perspectives on the portal, much of this concern comes prior to implementation. This kind of data asks whether the patient and provider would be willing to use the patient portal.

“One important limitation of this literature on patient portals is that studies of patient and provider perspectives on portal use focus on the pre-implementation or initial implementation phases and do not reflect how use and perspectives may change as users gain more experience,” the researchers said.

Understanding how experienced patient portal users perceive the tool is growing more important. Most hospitals and clinics have already adopted the patient portal in some capacity – in 2016, 92 percent of hospitals had adopted the patient portal, per an AHA report.

It is now less important to know whether stakeholders are willing to adopt the portal, and more important to understand how to improve the patient portal experience.

The research team also sought to understand patient and provider opinions about secure messaging functions. Secure messaging is emerging as a popular portal function because it allows patients and providers to forge deeper relationships.

Through qualitative interviews with 13 primary care providers and 29 of their chronic disease patients who are familiar with the Epic MyChart, the researchers found that perceptions about the patient portal have evolved over time.

“Our study suggests that initial concerns about overuse and security of information expressed by patients and providers in pre-implementation studies may no longer apply as users gain experience,” the team found. “Instead, experienced users identified concerns beyond the technical aspects of using a portal.”

In previous literature, providers expressed time constraint concerns about using secure messaging, for example. Now, patients and providers are more concerned about how to appropriately use secure messaging.

Patients reported worrying about abusing provider time and the lack of compensation providers receive for answering secure messages. Patients also expressed confusion about what is and is not an urgent matter that should be discussed via direct message.

Providers said they were concerned about communicating appropriately and sensitively with their patients.

“Unlike other portal features such as scheduling appointments or requesting prescription refills, secure messaging requires interaction with another individual and therefore users need to understand more than simply the technical aspects of how to access a feature,” the research team pointed out.

“Appropriate use requires an understanding of the type of information that should be conveyed via the portal and the etiquette rules of electronic communication,” the researchers continued.

Informed by patient and provider responses, the investigators offered a series of suggestions for enhancing patient-provider communication via the patient portal. The team suggested adding links in the sidebar of patient-facing messaging screens to help patients decide if their need is urgent.

The researchers also recommended guided messages that allow patients to fill in the blanks about their health needs. These templates should be flexible for patient editing and be offered in multiple formats to fit different needs.

While these findings are notable for improving patient and provider use of the patient portal, they also highlight how opinions about the tools can evolve over time.

“Patients struggle to balance their desire to respect their provider’s time with their need for answers to health-related questions,” the researchers said. “Providers are still figuring out how best to communicate with patients via portals in a way that addresses patient needs without overstepping boundaries.”

“These findings suggest that additional information and training on the ‘rules of engagement’ may help address the concerns of both patients and providers and improve the efficiency of communication via patient portals,” the team concluded.

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