Patient Portals: What's In It for Everyone

Gregory R. Weidner, MD


March 15, 2016

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Hi. I'm Dr Greg Weidner. I'm a practicing internist and the medical director for Primary Care Innovation and Proactive Health at Carolinas HealthCare System. This is the first in a series of Medscape videos on topics related to patient engagement and digital health.

Why patient engagement? A growing body of evidence demonstrates that patients who are more actively involved in their healthcare experience better health outcomes and incur lower costs. Therefore, thoughtfully and purposefully building solutions for patient engagement is an important part of our pursuit of the [Institute for Healthcare Improvement's] Triple Aim. These systems also provide an opportunity to promote practice operational efficiency by successfully engaging patients.

Today's topic is patient portals. We hope to share information and best practices to help you, your patients, and your practice team get the most out of these tools.

How can you and your practice team succeed in leveraging your patient portal for patient engagement and efficiency?

1. Build or select the features that patients find useful:

  • Secure messaging, which allows patients and caregivers to compose questions thoughtfully and confidentially without the stress of a time-limited in-person visit. It also provides the convenience of communicating asynchronously and allowing for touchpoints between visits.

  • Viewing test results, which helps promote understanding and allows patients to take a more active role in managing their healthcare, and often allows for trending over time.

  • Reviewing medical history—problems, medications, procedures, immunizations.

  • Appointment requests or direct online scheduling.

  • Bill payment.

  • Refill requests.

  • Access to education materials.

  • Asynchronous e-visits or virtual visits.

  • Family access.

  • Integrated portal with an electronic medical record (EMR), so that the patient or caregiver will be able to view the health information as captured in the EMR.

2. Make it easy for patients to enroll in and use the portal:

  • Provide convenient, in-person locations where patients can sign up with help from practice support staff. In a study of patient portal adoption conducted by athenahealth, more than one half of patients who began the registration process in the provider's office ultimately created portal accounts.[1] For patients who received text messages with portal login information before they left the practice, the portal conversion rate was about 25%. Finally, those receiving automated reminder emails were far less likely to register for the portal; only 4% of patients did so. 

  • Make it mobile, and accessible with any browser to minimize digital barriers.

  • Don't assume that an individual will or won't be interested in the patient portal. Age, education, and perceived digital savvy are not as predictive as you think. Offer it to everyone, and let them decide. You will be surprised at who may choose to use the portal. There is some evidence that those with chronic conditions may be more likely to use a patient portal. But in general, offer it to all of your patients, and let them decide the value that they see.


3. Clearly communicate to patients what is in it for them:

  • Simplicity and convenience. Relate it to using email, which is a familiar part of most patients' lives. Emphasize the asynchronous element: Instead of having to call the office during normal operating hours, they can send a message late at night after they finally have a moment to breathe, and receive a response the next day.

  • Integration. Let patients know that their message will go right into their chart, and that your practice staff and partners will have their message in context of their medical history before reviewing and responding.

  • Understanding and partnership. Patients can and should review their record for accuracy and provide updates or corrections—especially for dynamic elements, such as the medications list. If your practice offers OpenNotes, patients can even review the record of a recent office visit to reinforce the agreed-upon plan of action and promote understanding and execution of the plan.

  • Security. This is a significant concern for many patients, and it is worth addressing the security of your portal upfront.

4. Promote the portal:

  • Everyone in the office should be involved in promoting the portal.

  • The doctor's attitude and promotion of the portal is a particularly strong driver of patient and staff adoption.

  • Include the portal promotion on office hold messages and in mailings to patients with bills or lab results.

5. Establish policies and procedures:

  • Define response times for messages.

  • Define release time frames for test result.

  • Determine internal processes for routing messages and responses.

  • Clearly communicate to patients what their expectations should be and what constitutes appropriate and safe uses for the portal.

We hope these tips and tricks will help you to get the most out of your portal. We'd love to hear about what has worked for you in your practice, so please share in the comments.

We look forward to continuing this series on patient engagement and digital health. We wish you and your patients the best of health. Thank you.

Suggested Reading

Clain D. athenaResearch study: The current state of patient portal adoption. athenahealth. July 30, 2015. Accessed March 7, 2016.

Graham C. Study: how patients want to communicate with their physician. TechnologyAdvice. August 13, 2014. Accessed March 7, 2016.

Henry SL, Shen E, Ahuja A, Gould MK, Kanter MH. The online personal action plan: a tool to transform patient-enabled preventive and chronic care. Am J Prev Med. 2016 Jan 25. [Epub ahead of print]

HIMSS. Using patient portals to achieve meaningful use (EP edition). December 1, 2014. Accessed March 7, 2016.


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