Patient Portals Go Under The Microscope In New Study

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This month’s Journal of Medical Internet Research includes findings from a study designed to assess the effectiveness of patient portals and, more specifically, the impact they have on quality outcomes. For the past 10 years, there has been a small but growing market for patient portals. Early on, as with most technology in healthcare, it was large teaching hospitals going live with portals. However, in 2011, the ARRA Meaningful Use program mandated that all hospitals and practices provide patients with an online portal, and adoption has since skyrocketed.

Since 2011, there have been thousands of studies attempting to correlate the implementation of a patient portal with some kind of quality improvement in outcomes. In this study, researchers at Texas State University’s College of Health Professionals assessed over 5,000 published studies on the subject, and from those, selected 27 representative studies to include in their systematic review.

Despite growing adoption rates, researchers found very little evidence correlating portals with quality improvements. Researchers used the Agency for Healthcare Research and Quality’s (AHRQ) indicators of quality as a standard definition of quality improvements. Of the 27 studies reviewed, only 37 percent found that portals had a positive impact on quality improvements. Although for those studies that did measure improvements, the gains were in some important areas in which wins have not come easily, notably medication adherence, self-management of disease, a decrease of office visits, and an increase in preventative medicine practices. Portal use was also associated with increased customer retention, which researchers considered a positive factor due to its impact on overall continuity of care.

An important note is that of the 27 studies selected for review, none were randomized control trials, a point researchers went out of their way to make. In fact, 89 percent of the studies evaluated in the systematic review were labeled “non-experimental” in design, meaning that researchers could not control and measure cause and effect within the study. As a parting recommendation, the researchers involved in this system review recommended more RCT studies designed to accurately measure portal adoption and its influence on quality indicators.


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