Using Patient Portals to Improve Patient Outcomes: Systematic Review

Hae-Ra Han; Kelly T Gleason; Chun-An Sun; Hailey N Miller; Soo Jin Kang; Sotera Chow; Rachel Anderson; Paul Nagy; Tom Bauer

doi:10.2196/15038

Using Patient Portals to Improve Patient Outcomes: Systematic Review

JMIR Hum Factors. 2019 Dec 19;6(4):e15038. doi: 10.2196/15038.

Authors

Hae-Ra Han^{1

2

3}, Kelly T Gleason¹, Chun-An Sun¹, Hailey N Miller¹, Soo Jin Kang⁴, Sotera Chow¹, Rachel Anderson¹, Paul Nagy⁵, Tom Bauer⁶

Affiliations

¹ The Johns Hopkins University, School of Nursing, Baltimore, MD, United States.
² The Johns Hopkins University, Center for Cardiovascular and Chronic Care, Baltimore, MD, United States.
³ The Johns Hopkins University, Center for Community Innovation and Scholarship, Baltimore, MD, United States.
⁴ Daegu University, Department of Nursing, Daegu, Republic of Korea.
⁵ The Johns Hopkins University, School of Medicine, Baltimore, MD, United States.
⁶ The Johns Hopkins Hospitals and Health System, Baltimore, MD, United States.

PMID: 31855187
PMCID: PMC6940868
DOI: 10.2196/15038

Abstract

Background: With the advent of electronic health record (EHR) systems, there is increasing attention on the EHR system with regard to its use in facilitating patients to play active roles in their care via secure patient portals. However, there is no systematic review to comprehensively address patient portal interventions and patient outcomes.

Objective: This study aimed to synthesize evidence with regard to the characteristics and psychobehavioral and clinical outcomes of patient portal interventions.

Methods: In November 2018, we conducted searches in 3 electronic databases, including PubMed, EMBASE, and Cumulative Index to Nursing and Allied Health Literature, and a total of 24 articles met the eligibility criteria.

Results: All but 3 studies were conducted in the United States. The types of study designs varied, and samples predominantly involved non-Hispanic white and highly educated patients with sizes ranging from 50 to 22,703. Most of the portal interventions used tailored alerts or educational resources tailored to the patient's condition. Patient portal interventions lead to improvements in a wide range of psychobehavioral outcomes, such as health knowledge, self-efficacy, decision making, medication adherence, and preventive service use. Effects of patient portal interventions on clinical outcomes including blood pressure, glucose, cholesterol, and weight loss were mixed.

Conclusions: Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes. Understanding the role of patient portals as an effective intervention strategy is an essential step to encourage patients to be actively engaged in their health care.

Keywords: intervention study; patient portal; systematic review.

©Hae-Ra Han, Kelly T Gleason, Chun-An Sun, Hailey N Miller, Soo Jin Kang, Sotera Chow, Rachel Anderson, Paul Nagy, Tom Bauer. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 19.12.2019.

Publication types

Review

Grants and funding

KL2 TR003099/TR/NCATS NIH HHS/United States