Benefits of patient portals not yet clear

December 2, 2013

A systematic review of studies of patient portals finds insufficient evidence that they improve health outcomes or utilization, or lower costs.

Physicians’ and healthcare institutions’ use of patient portals has been growing rapidly in recent years, driven in part by legislation and government mandates mandating the use of electronic health record systems-most of which now include a patient portal-and in part by the belief that portals will enhance patient satisfaction, and improve the efficiency and quality of care. And although portals may some day achieve those goals, a recent study published in the November issue of Annals of Internal Medicine finds inconclusive evidence so far that portals are improving health outcomes, patient satisfaction, or patient utilization and efficiency.

Researchers conducted a systematic review of patient portal literature published between 1990 and the start of 2013, looking for evidence that portals improve health outcomes, patient satisfaction, or efficiency. They also evaluated evidence regarding the attitudes and characteristics of patients who use portals, as well as factors making portals more or less accessible.

The study looked just at portals that were “tethered” to EHR systems, as opposed to stand-alone systems used only for secure messaging between patients and providers. Researchers found that most such tethered portals shared common features, such as the ability to view test results, progress notes, and visit summaries, view and refill medications, view and make appointments, access educational materials, and send messages in a secure format.

Due to a lack of high-quality studies, however, the researchers were unable to draw any definitive conclusions about the impact of patient portals on health outcomes. Several of the studies they examined associated portal use with improved outcomes among patients with chronic diseases such as diabetes and hypertension, but generally those were studies in which portals were used in conjunction with case management.

They also found that patient use of portals is affected by race and ethnicity, educational and literacy levels, and number of medical problems. These factors are potential barriers to the goal of using portals as a way to make patients more active participants in their care, the authors say.