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Which Patient Portal Features Deliver the Best Care Outcomes?

For the best care outcomes, patient portal users might want to focus on secure messaging with providers.

By Sara Heath

- If it seemed as though the healthcare industry is continuously touting the benefits of patient portal use on overall health and wellness, you wouldn’t be wrong. Study after study suggests that patients who use the portal are more engaged with their care, and are generally healthier.

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But new research shows that improved outcomes go beyond general porta adoption. The technology is nuanced, and different features have more profound effects on different patients.

Recently published in the Journal of Medical Internet Research, a study lead by Stephanie L. Shimada, PhD, shows that sustained patient portal use is effective in improving health for patients with diabetes, but those effects vary depending on whether the patient uses electronic prescription refill or secure direct messaging.

Shimada and her research team determined this by looking at patient portal usage at the Department of Veteran’s Affairs between 2010 and 2014. After investigating the associated health benefits of the tool, the researchers saw that patients used electronic prescription refill more frequently, but those who used secure direct messaging saw better health benefits.

“The rate of use and increase in use was greater for Web-based refills than for [secure messaging],” the researchers reported.

“We observed small, statistically significant, and potentially meaningful improvement in physiological measures among diabetic patients who initiated and sustained use of Web-based refills or SM or both via MHV. However, the association varied by specific MHV feature. Where a significant association was found, use of SM was associated with higher odds of improved outcomes than use of Web-based refills.”

Further, the researchers used an algorithm to adjust the frequency of patient use for electronic refill and secure messaging and predicted their health outcomes. This helped determine who the two different features impacted patient health in different ways.

“Adjusting for use of both the features in the model did shift the magnitude of the odds of achieving control,” the research team said. “This suggests that the association between patient portal use and health outcomes will vary based on the combination of different features used and how patients are using each feature for self-management of their health conditions.”

With regard to secure messaging, Shimada and colleagues said patients who used this feature likely saw better health because it boosts patient-provider communication. Because patients consult with their providers more frequently, providers are able to adjust medications, remind patients to adhere to treatment plans, answer questions, and coordinate care between patients and other providers.

Electronic refill, while also effective in improving diabetic care, likely had a less powerful effect because its impact was generally limited to medication adherence. Because receiving medications was made easier through the use of a web-based tool, patients were more likely to refill prescriptions and take those medications.

“To the extent that Web-based refills increase the likelihood of refilling prescriptions, they may improve availability of medications, which may lead to improvements in adherence,” the team said.

Shimada and the research team emphasized that this research shows how nuanced patient portal use is. While most studies examine the effects of the tool as a whole or only one feature within the portal, it does not take into account how different features can influence one another.

“This work also expands on previous research that has often focused generally on the patient portal or PHR use or the use of a particular feature such as SM, without accounting for their relative effects when used in combination with other features,” the team explained.

“As features continue to be added to portals, further research should continue to examine the effects of different portal features both separately and in combination, to determine which features are most effective at improving the specific patient outcomes of interest.”

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