International Journal of Medical Informatics
Volume 79, Issue 7 , Pages 469-477 , July 2010

Issues and questions to consider in implementing secure electronic patient–provider web portal communications systems

  • Douglas S. Wakefield

      Affiliations

    • University of Missouri, Center for Health Care Quality and Department of Health Management and Informatics, United States
    • Corresponding Author InformationCorresponding author at: Center for Health Care Quality, CE548, One Hospital Drive, Columbia, MO 65212, United States. Tel.: +1 573 882 6578.
    • ,
  • David Mehr

      Affiliations

    • University of Missouri, Department of Family and Community Medicine, United States
    • ,
  • Lynn Keplinger

      Affiliations

    • University of Missouri, Department of Medicine, United States
    • ,
  • Shannon Canfield

      Affiliations

    • University of Missouri, Department of Family and Community Medicine, United States
    • ,
  • Rajitha Gopidi

      Affiliations

    • University of Missouri, Center for Health Care Quality and Department of Health Management and Informatics, United States
    • ,
  • Bonnie J. Wakefield

      Affiliations

    • Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Department of Veterans Affairs Medical Center Iowa City, IA and the University of Missouri Sinclair School of Nursing, United States
    • ,
  • Richelle J. Koopman

      Affiliations

    • University of Missouri, Department of Family and Community Medicine, United States
    • ,
  • Jeffery L. Belden

      Affiliations

    • University of Missouri, Department of Family and Community Medicine, United States
    • ,
  • Robin Kruse

      Affiliations

    • University of Missouri, Department of Family and Community Medicine, United States
    • ,
  • Karl M. Kochendorfer

      Affiliations

    • University of Missouri, Department of Family and Community Medicine, United States

Received 20 January 2010 ,Revised 19 April 2010 ,Accepted 21 April 2010.

References 

  1. Hassol A, Walker JM, Kidder D, Rokita K, Young D, Pierdon S, et al. Patient experiences and attitudes about access to a patient electronic health care record and linked web messaging. J. Am. Med. Inform. Assoc. 2004;11(6):505–513
  2. Chen C, Garrido T, Chock D, Okawa G, Laing L. The Kaiser permanente electronic health record: transforming and streamlining modalities of care. Health Affairs (Millwood). 2009;28(2):323–333
  3. Ralston JD, Martin DP, Anderson ML, Fishman PA, Conrad DA, Larson EB, et al. Group health cooperative's transformation toward patient-centered access. Med. Care Res. Rev. 2009;66(6):703–724
  4. Harris LT, Martin DP, Haneuse SJ, Ralston JD. Diabetes quality of care and outpatient utilization associated with electronic patient–provider messaging: a cross-sectional analysis. Diabetes Care. 2009;32(7):1182–1187
  5. Fullerton C, Aponte P, Hopkins R, Bragg D, Ballard DJU. Lesson learned from pilot site implementation of an ambulatory electronic health record. Proc. Bayl. Univ. Med. Cent. 2006;19(4):303–310
  6. Bryne JM, Elliott S, Firek A. Initial experience with patient–clinician secure messaging at a VA medical center. J. Am. Med. Inform. Assoc. 2009;16(2):267–270
  7. Zickmund SL, Hess R, Bryce CL, McTigue K, Olshansky E, Fitzgerald K, et al. Interest in the use of computerized patient portals: role of the provider–patient relationship. J. Gen. Intern. Med. 2008;23(Suppl. 1):20–26
  8. McGeady D, Kujala J, Ilvonen K. The impact of patient–physician web messaging on healthcare service provision. Int. J. Med. Inform. 2008;77(1):17–23
  9. Katz SJ, Moyer CA. The emerging role of online communication between patients and their providers. J. Gen. Intern. Med. 2004;19(9):978–983
  10. Houston TK, Sands DZ, Jenckes MW, Ford DE. Experiences of patients who were early adopters of electronic communication with their physician: satisfaction, benefits and concerns. Am. J. Manage. Care. 2004;10(9):601–608
  11. Lin CT, Wittevrongel L, Moore L, Beaty BL, Ross SE. An internet-based patient–provider communication system: randomized controlled trial. J. Med. Internet Res. 2005;7:e47
  12. Wallwiener M, Wallwiener CW, Kansy JK, Seeger H, Rajab TK. Impact of electronic messaging on the patient-physician interaction. J. Telemed. Telecare. 2009;15(5):243–250
  13. Sittig DF. Results of a content analysis of electronic messages (email) sent between patients and their physicians. BMC Med. Inform. Decis. Making. 2003;3:11
  14. Leong SL, Gingrich D, Lewis PR, Mauger DT, George JH. Enhancing doctor–patient communication using email: a pilot study. J. Am. Board Family Pract. 2005;18(3):180–188
  15. Matheny ME, Gandhi TK, Orav EJ, Ladak-Merchant Z, Bates DW, Kuperman GJ, et al. Impact of an automated test results management system on patients’ satisfaction about test result communication. Arch. Intern. Med. 2007;167(20):2233–2239
  16. Ralston JD, Carrell D, Reid R, Anderson M, Moran M, Hereford J. Patient web services integrated with a shared medical record: patient use and satisfaction. J. Am. Med. Inform. Assoc. 2007;14(6):798–806
  17. Liederman EM, Morefield CS. Web messaging: a new tool for patient–physician communication. J. Am. Med. Inform. Assoc. 2003;10(3):260–270
  18. Ross SE, Moore LA, Earnest MA, Wittevrongel L, Lin CT. Providing a web-based online medical record with electronic communication capabilities to patients with congestive heart failure: randomized trial. J. Med. Internet Res. 2004;6(May (2)):e12
  19. Hereford J, Bell E, Lee J, Eytan T. Patient satisfaction with a web-based patient–provider messaging system implemented across a statewide delivery system (Group Health Cooperative). In: AMIA Annu. Symp. Proc.. 2003;p. 860
  20. Adler KG. Web portals in primary care: an evaluation of patient readiness and willingness to pay for online services. J. Med. Internet Res. 2006;8(4):e26
  21. Harris Interactive. Patient/physician online communication: many patients want it, would pay for it, and it would influence their choice of doctors and health plans. Health Care News. 2002;2(8):1–4
  22. Fowles JB, Kind AC, Craft C, Kind EA, Mandel JL, Adlis S. Patients’ interest in reading their medical record: relation with clinical and sociodemographic characteristics and patients’ approach to health care. Arch. Intern. Med. 2004;164(7):793–800
  23. Bryce CL, Zickmund S, Hess R, McTigue KM, Olshansky E, Fitzgerald K, et al. Value versus user fees: perspectives of patients before and after using a web-based portal of management of diabetes. Telemed. J. E: Health. 2008;14(10):1035–1043
  24. Kleiner KD, Akers R, Burke BL, Werner EJ. Patient and physician attitudes regarding electronic communications in pediatric practices. Pediatrics. 2002;109(5):740–744
  25. Sorensen L, Shaw R, Casey E. Patient portals: survey of nursing informaticists. Stud. Health Technol. Inform. 2009;146:160–165
  26. Delbanco T, Sands DZ. Electrons in flight—e-mail between doctors and patients. N. Engl. J. Med. 2004;350(17):1705–1707
  27. Katz SJ, Nissan N, Moyer CA. Crossing the digital divide: evaluating online communication between patients and their providers. Am. J. Manage. Care. 2004;10(9):593–598
  28. White CB, Moyer CA, Stern DT, Katz SJ. A content analysis of E-mail communication between patients and their providers: patients get the message. J. Am. Med. Inform. Assoc. 2004;11(4):260–267
  29. Couchman GR, Forjuoh SN, Rascoe TG, Reis MD, Koehler B, Walsum KL. E-mail communications in primary care: what are patients’ expectations for specific test results?. Int. J. Med. Inform. 2005;74(January (1)):21–30
  30. Sittig DF, King S, Hazlehurst BL. A survey of patient–provider e-mail communication: what do patients think?. Int. J. Med. Inform. 2001;61(1):71–80
  31. Tjora A, Tran T, Faxvaag A. Privacy vs. usability: a qualitative exploration of patients’ experiences with secure internet communication with their general practitioner. J. Med. Internet Res. 2005;7(2):e15
  32. Katz SJ, Moyer CA, Cox DT, Stern DT. Effect of a triage-based e-mail system on clinic resource use and patient and physician satisfaction in primary care. J. Gen. Intern. Med. 2003;18(9):736–744
  33. Liederman EM, Lee JC, Baquero VH, Seites PG. The impact of patient–physician web messaging on provider productivity. J. Healthcare Inform. Manage. 2005;19(2):81–86
  34. Neville RG, Marsden W, McCowan C, Pagliari C, Mullen H, Fannin A. A survey of GP attitudes to and experiences of email consultations. Inform. Prim. Care. 2004;12(4):201–206
  35. Kittler AF, Carlson GL, Harris C, Lippincott M, Pizziferri L, Volk LA, et al. Primary care physician attitudes towards using a secure web-based portal designed to facilitate electronic communication with patients. Inform. Prim. Care. 2004;12(3):129–138
  36. Hobbs J, Wald J, Jagannath YS, Kittler A, Pizziferri L, Volk LA, et al. Opportunities to enhance patient and physician e-mail contact. Int. J. Med. Inform. 2003;70(1):1–9
  37. Ralston JD, Rutter CM, Carrell D, Hecht J, Rubanowice D, Simon GE. Patient use of secure electronic messaging within a shared medical record: a cross-sectional study. J. Gen. Intern. Med. 2009;24(3):349–355
  38. Zhou YY, Garrido T, Chin HL, Wiesenthal AM, Liang LL. Patient access to an electronic health record with secure messaging: impact on primary care utilization. Am. J. Manage. Care. 2007;13(7):418–424
  39. Roter DL, Larson S, Sands DZ, Ford DE, Houston T. Can e-mail messages between patients and physicians be patient-centered?. Health Commun. 2008;23(1):80–86
  40. Grant RW, Wald JS, Schnipper JL, Gandhi TK, Poon EG, Orav EJ, et al. Practice-linked online personal health records for type 2 diabetes mellitus. Arch. Intern. Med. 2008;168(16):1776–1782
  41. Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, et al. Effectiveness of home blood pressure monitoring, web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA. 2008;299(24):2857–2867
  42. Bergmo TS, Kummervold PE, Gammon D, Dahl LB. Electronic patient–provider communication: will it offset office visits and telephone consultations in primary care?. Int. J. Med. Inform. 2005;74(9):705–710
  43. Reijonsaari K, McGeady D, Kujala J, Ekroos N. Effects of E-health on health care service production processes-case study: Palo alto online. In: International Conference on the Management of Healthcare & Medical Technology. Aalborg, Denmark, August 25–26. 2005;p. 62–73
  44. Wu RC, Delgado D, Costigan J, Maciver J, Ross H. Pilot study of an internet patient–physician communication tool for heart failure disease management. J. Med. Internet Res. 2005;7(1):e8
  45. Anand SG, Feldman MJ, Geller DS, Bisbee A, Bauchner H. A content analysis of e-mail communication between primary care providers and parents. Pediatrics. 2005;115(5):1283–1288
  46. Wald JS, Burk K, Gardner K, Feygin R, Nelson E, Epstein M, et al. Sharing electronic laboratory results in a patient portal—a feasibility pilot. Stud. Health Technol. Inform. 2007;129(Pt 1):18–22
  47. Hess R, Bryce CL, Paone S, Fischer G, McTigue KM, Olshansky E, et al. Exploring challenges and potentials of personal health records in diabetes self-management: implementation and initial assessment. Telemed. J. E: Health. 2007;13(5):509–517
  48. Britto MT, Jimison HB, Munafo JK, Wissman J, Rogers ML, Hersh W. Usability testing finds problems for novice users of pediatric portals. J. Am. Med. Inform. Assoc. 2009;16(5):660–669
  49. Atreja A, Mehta N, Miller D, Moore S, Nichols K, Miller H, et al. One size does not fit all: using qualitative methods to inform the development of an internet portal for Multiple Sclerosis patients. In: AMIA Annu. Symp. Proc., vols. 16–20. 2005;
  50. Shaw E, Howard M, Chan D, Waters H, Kaczorowski J, Price D, et al. Access to web-based personalized antenatal health records for pregnant women: a randomized controlled trial. J. Obstet. Gynaecol. Can. 2008;30(1):38–43
  51. Ketteridge G, Delbridge H, Delbridge L. How effective is email communication for patients requiring elective surgery?. ANZ J. Surg. 2005;75(8):680–683
  52. Car J, Sheikh A. Email consultations in health care. 2. Acceptability and safe application. BMJ. 2004;329(7463):439–442
  53. Ruland CM, Brynhi H, Andersen R, Bryhni T. Developing a shared electronic health record for patients and clinicians. Stud. Health Technol. Inform. 2008;136:57–62
  54. Office of Health Information Technology, Meaningful Use, http://healthit.hhs.gov/portal/server.pt?open=512&objID=1325&parentname=CommunityPage&parentid=1&mode=2 (accessed 12/10/09).
  55. Bachman JW. The patient–computer interview: a neglected tool that can aid the clinician. Mayo Clin. Proc. 2003;78(1):67–78

PII: S1386-5056(10)00094-8

doi: 10.1016/j.ijmedinf.2010.04.005

International Journal of Medical Informatics
Volume 79, Issue 7 , Pages 469-477 , July 2010

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