Portals in Inpatient Care: Evaluating the Usability, Use, and Patient Experience Associated With Patient Portal Technology at the Bedside

Many policymakers and health advocates believe increased use of patient portals will empower patients to engage in better management of their care, resulting in healthier populations and lower costs. Patient portals provide patients access to their electronic medical record (EMR) information and often include functions such as secure communication with their providers. Little is known about what motivates patients to adopt and continue to use portals, including the functionalities patients consider important for self-management of health conditions. Current research on patient engagement in the inpatient setting is limited to small-scale qualitative case studies examining a few technological parameters such as access to medication records or care team information.

Researchers assessed Ohio State University Wexner Medical Center’s experience with implementing an inpatient portal through a commercially available tablet-based application to improve understanding of the potential and impact of this new technology. The study evaluated usability, use, and experience with the portal to gain a greater understanding of the process, content, and context in which this tool is embedded in an EMR and continues to evolve.

The specific aims of the project were as follows:

• Conduct a mixed-method evaluation of an inpatient portal’s use and related impacts on usability, use, and experience through a three-track evaluation approach. 
• Build a Logic Model for assessment of an inpatient personal health record, drawing upon the knowledge gained in the first aim. 

This mixed-method study assessed three evaluations tracks: 1) how patients could interact with an inpatient portal, 2) how patients used the portal, and 3) how use of the portal impacted patient experience and engagement. Researchers conducted stakeholder interviews with patients and providers, a usability study, and quantitative analysis of portal log data files. The findings from these three evaluation tracks informed the development of a logic model for evaluation of a patient portal.

Usability studies showed that errors encountered by portal users were attributable to issues with system design, assumptions about functionalities, and insufficient user knowledge. Patients reported that access to the portal made them feel more in control of their care and able to ask better questions. Some providers reported that teaching patients how to use it was beyond their scope of work, while others noted it was a good tool or “had potential” to help patients. Patient portals show promise as a tool that can facilitate patient engagement and improve patients’ experiences. The design of inpatient portals can greatly impact how patients navigate and comprehend information in inpatient portals; poor design can result in a frustrating user experience. With a detailed understanding of user experience associated with using these tools, hospitals can be better positioned to support and encourage patient use of the tool.