Patient portals

Patient portals can give patients access to a personal health record and enable interaction with the health care system. Patient portals are creating unprecedented opportunities for using health IT to deliver care to patients, paving the way for benefits to patients, providers and the organizations that implement the portals. The objective of this dissertation has been to explore the role of the organizational context by identifying and describing factors affecting portals in different types of health service systems.

We have let the following four questions guide the research. 1. What outcomes have been achieved through patient portals and how are these outcomes achieved? 2. How does the health service system context, in particular health service system integration or fragmentation, impact patient portal development and ability to achieve beneficial outcomes? 3. With focus on fragmented health service systems, how can patient portal development and achievement of beneficial outcomes be improved? 4. How can the existing evidence base inform patient portal development across health service systems and how can this evidence base be advanced?

In answering these questions, we studied portals in integrated and fragmented health service systems in the United States and in the Netherlands. We relied on multiple qualitative methods, including literature review, document analysis, and interviews.