scholarly journals Characterizing Patient-Clinician Communication in Secure Medical Messages: Retrospective Study (Preprint)

2021 ◽  
Author(s):  
Ming Huang ◽  
Jungwei Fan ◽  
Julie Prigge ◽  
Nilay D Shah ◽  
Brian A Costello ◽  
...  
Keyword(s):  
Primary Care ◽  
Nurse Practitioner ◽  
Mayo Clinic ◽  
Communication Complexity ◽  
Physician Assistant ◽  
Wide Spectrum ◽  
Patient Portal ◽  
Patient Portals ◽  
Secure Messaging ◽  
Clinician Communication

BACKGROUND Patient-clinician secure messaging is an important function in patient portals and enables patients and clinicians to communicate on a wide spectrum of issues in a timely manner. With its growing adoption and patient engagement, it is time to comprehensively study the secure messages and user behaviors in order to improve patient-centered care. OBJECTIVE The aim of this paper was to analyze the secure messages sent by patients and clinicians in a large multispecialty health system at Mayo Clinic, Rochester. METHODS We performed message-based, sender-based, and thread-based analyses of more than 5 million secure messages between 2010 and 2017. We summarized the message volumes, patient and clinician population sizes, message counts per patient or clinician, as well as the trends of message volumes and user counts over the years. In addition, we calculated the time distribution of clinician-sent messages to understand their workloads at different times of a day. We also analyzed the time delay in clinician responses to patient messages to assess their communication efficiency and the back-and-forth rounds to estimate the communication complexity. RESULTS During 2010-2017, the patient portal at Mayo Clinic, Rochester experienced a significant growth in terms of the count of patient users and the total number of secure messages sent by patients and clinicians. Three clinician categories, namely “physician—primary care,” “registered nurse—specialty,” and “physician—specialty,” bore the majority of message volume increase. The patient portal also demonstrated growing trends in message counts per patient and clinician. The “nurse practitioner or physician assistant—primary care” and “physician—primary care” categories had the heaviest per-clinician workload each year. Most messages by the clinicians were sent from 7 AM to 5 PM during a day. Yet, between 5 PM and 7 PM, the physicians sent 7.0% (95,785/1,377,006) of their daily messages, and the nurse practitioner or physician assistant sent 5.4% (22,121/408,526) of their daily messages. The clinicians replied to 72.2% (1,272,069/1,761,739) patient messages within 1 day and 90.6% (1,595,702/1,761,739) within 3 days. In 95.1% (1,499,316/1,576,205) of the message threads, the patients communicated with their clinicians back and forth for no more than 4 rounds. CONCLUSIONS Our study found steady increases in patient adoption of the secure messaging system and the average workload per clinician over 8 years. However, most clinicians responded timely to meet the patients’ needs. Our study also revealed differential patient-clinician communication patterns across different practice roles and care settings. These findings suggest opportunities for care teams to optimize messaging tasks and to balance the workload for optimal efficiency.

scholarly journals Characteristics of Patients Using Different Patient Portal Functions and the Impact on Primary Care Service Utilization and Appointment Adherence: Retrospective Observational Study

10.2196/14410 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e14410 ◽  
Author(s):  
Xiang Zhong ◽  
Jaeyoung Park ◽  
Muxuan Liang ◽  
Fangyun Shi ◽  
Pamela R Budd ◽  
...  
Keyword(s):  
Primary Care ◽  
Service Utilization ◽  
Care Delivery ◽  
Care Service ◽  
Primary Care Service ◽  
Patient Portal ◽  
Patient Portals ◽  
Appointment Adherence ◽  
Primary Care Patients ◽  
The Impact

Background Patient portals are now widely available and increasingly adopted by patients and providers. Despite the growing research interest in patient portal adoption, there is a lack of follow-up studies describing the following: whether patients use portals actively; how frequently they use distinct portal functions; and, consequently, what the effects of using them are, the understanding of which is paramount to maximizing the potential of patient portals to enhance care delivery. Objective To investigate the characteristics of primary care patients using different patient portal functions and the impact of various portal usage behaviors on patients’ primary care service utilization and appointment adherence. Methods A retrospective, observational study using a large dataset of 46,544 primary care patients from University of Florida Health was conducted. Patient portal users were defined as patients who adopted a portal, and adoption was defined as the status that a portal account was opened and kept activated during the study period. Then, users were further classified into different user subgroups based on their portal usage of messaging, laboratory, appointment, and medication functions. The intervention outcomes were the rates of primary care office visits categorized as arrived, telephone encounters, cancellations, and no-shows per quarter as the measures of primary care service utilization and appointment adherence. Generalized linear models with a panel difference-in-differences study design were then developed to estimate the rate ratios between the users and the matched nonusers of the four measurements with an observational window of up to 10 quarters after portal adoption. Results Interestingly, a high propensity to adopt patient portals does not necessarily imply more frequent use of portals. In particular, the number of active health problems one had was significantly negatively associated with portal adoption (odds ratios [ORs] 0.57-0.86, 95% CIs 0.51-0.94, all P<.001) but was positively associated with portal usage (ORs 1.37-1.76, 95% CIs 1.11-2.22, all P≤.01). The same was true for being enrolled in Medicare for portal adoption (OR 0.47, 95% CI 0.41-0.54, P<.001) and message usage (OR 1.44, 95% CI 1.03-2.03, P=.04). On the impact of portal usage, the effects were time-dependent and specific to the user subgroup. The most salient change was the improvement in appointment adherence, and patients who used messaging and laboratory functions more often exhibited a larger reduction in no-shows compared to other user subgroups. Conclusions Patients differ in their portal adoption and usage behaviors, and the portal usage effects are heterogeneous and dynamic. However, there exists a lack of match in the patient portal market where patients who benefit the most from patient portals are not active portal adopters. Our findings suggest that health care delivery planners and administrators should remove the barriers of adoption for the portal beneficiaries; in addition, they should incorporate the impact of portal usage into care coordination and workflow design, ultimately aligning patients’ and providers’ needs and functionalities to effectively deliver patient-centric care.

scholarly journals A Retrospective Analysis of Provider-to-Patient Secure Messages: How Much Are They Increasing, Who Is Doing the Work, and Is the Work Happening After Hours? (Preprint)

2019 ◽  
Author(s):  
Frederick North ◽  
Kristine E Luhman ◽  
Eric A Mallmann ◽  
Toby J Mallmann ◽  
Sidna M Tulledge-Scheitel ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Care Physician ◽  
Work Hours ◽  
Patient Portal ◽  
Secure Messaging ◽  
After Hours ◽  
Over Time

BACKGROUND Patient portal registration and the use of secure messaging are increasing. However, little is known about how the work of responding to and initiating patient messages is distributed among care team members and how these messages may affect work after hours. OBJECTIVE This study aimed to examine the growth of secure messages and determine how the work of provider responses to patient-initiated secure messages and provider-initiated secure messages is distributed across care teams and across work and after-work hours. METHODS We collected secure messages sent from providers from January 1, 2013, to March 15, 2018, at Mayo Clinic, Rochester, Minnesota, both in response to patient secure messages and provider-initiated secure messages. We examined counts of messages over time, how the work of responding to messages and initiating messages was distributed among health care workers, messages sent per provider, messages per unique patient, and when the work was completed (proportion of messages sent after standard work hours). RESULTS Portal registration for patients having clinic visits increased from 33% to 62%, and increasingly more patients and providers were engaged in messaging. Provider message responses to individual patients increased significantly in both primary care and specialty practices. Message responses per specialty physician provider increased from 15 responses per provider per year to 53 responses per provider per year from 2013 to 2018, resulting in a 253% increase. Primary care physician message responses increased from 153 per provider per year to 322 from 2013 to 2018, resulting in a 110% increase. Physicians, nurse practitioners, physician assistants, and registered nurses, all contributed to the substantial increases in the number of messages sent. CONCLUSIONS Provider-sent secure messages at a large health care institution have increased substantially since implementation of secure messaging between patients and providers. The effort of responding to and initiating messages to patients was distributed across multiple provider categories. The percentage of message responses occurring after hours showed little substantial change over time compared with the overall increase in message volume.

Novel use of existing technology: A preliminary study of patient portal use for telerehabilitation

2020 ◽  
pp. 1357633X2095017
Author(s):  
Susan S Conroy ◽  
Stacey Harcum ◽  
Linda Keldsen ◽  
Christopher T Bever
Keyword(s):  
Care Delivery ◽  
Health Service Delivery ◽  
Patient Portal ◽  
Significant Other ◽  
Patient Portals ◽  
Secure Messaging ◽  
Exercise Time ◽  
Stroke Population ◽  
Therapist Communication ◽  
Randomised Controlled

Patient portals (PPs) foster engagement and self-management of chronic disease and are emerging as extensions of the care continuum. Utilisation from a health service delivery perspective is growing; however, it is a relatively new model of care in the field of rehabilitation. This pilot, within a larger randomised controlled stroke rehabilitation trial, explored the feasibility and acceptance of secure messaging using an established nationwide PP system for e-visits. Fifteen participants with stroke-related arm disability were randomised to 6 weeks of home arm telerehabilitation. All were over the age of 60 and 73% lived with a spouse or significant other. Mean intervention time was 6.8 weeks, and participants sent 2.3 ± 1.4 messages per week to complete 15.1 h of reported therapy (prescribed therapy = 18 h). Portal use improved therapist efficiency and resulted in a 1:6 therapist to patient exercise time ratio compared with the conventional 1:1 ratio for in-person therapy. Low initial electronic health literacy, self-efficacy or cognitive scores did not prohibit utilisation, and satisfaction with secure messaging for patient–therapist communication was 3.5 ± 1.2 out of 5. Overall, PP-supported e-visits were a feasible and acceptable telerehabilitation care delivery method for this chronic stroke population. ClinicalTrials.gov Identifier NCT02665052. Registered 27 January 2016. https://clinicaltrials.gov/ct2/show/NCT02665052

scholarly journals Optimization of Primary Care Among Black Americans Using Patient Portals: A Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Omar H Ordaz ◽  
Raina L Croff ◽  
LaTroy D Robinson ◽  
Steven A Shea ◽  
Nicole P Bowles
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Black Americans ◽  
The United States ◽  
Black American ◽  
Patient Portal ◽  
Treatment Team ◽  
Patient Portals

BACKGROUND The existence of lower patient portal use among Black Americans is concerning as portals have been shown to improve the control of chronic conditions that are more prevalent and deadlier in Black Americans than the rest of the population. Portal websites at their very simplest connect patients to their electronic health records and often provide tools for patients to interact with their own health information, treatment team members, and insurance companies. However, research suggests that Black American patients have greater concerns over lack of support, loss of privacy, and reduced personalization of care relative to others in the population, which results in a disparity of portal use. OBJECTIVE This qualitative investigation of primary care experiences of Black Americans from across the United States, who participated in remote focus groups in April and May 2020, explores the use and perceived value of patient portal websites to better understand any barriers to optimized treatment in the primary care setting. METHODS To qualitatively assess the experiences of Black American patients with regular access to portal websites, we performed inductive thematic analysis of eight remote focus group interviews with Black American patients aged 30-60. RESULTS Thematic analysis uncovered the following interrelated themes regarding patient portals in primary care: 1) optimization of care; 2) patient empowerment; 3) patient-provider communication; and 4) patient burden. CONCLUSIONS In contrast to what has been described regarding reluctance of Black Americans to engage with patient portals, our focus groups revealed general acceptance of patient portals, which were described overwhelmingly as tools with potential for exceptional, personalized care that may even work to mitigate the unfair burden of disease for Black Americans in primary care settings. Thus, opportunities for better health care clearly exist with increased communication, experience and adoption of remote health care practices among Black Americans.

scholarly journals Characteristics of Patients Using Different Patient Portal Functions and the Impact on Primary Care Service Utilization and Appointment Adherence (Preprint)

2019 ◽  
Author(s):  
Xiang Zhong ◽  
Jaeyoung Park ◽  
Muxuan Liang ◽  
Fangyun Shi ◽  
Pamela R. Budd ◽  
...  
Keyword(s):  
Primary Care ◽  
Service Utilization ◽  
Care Service ◽  
Office Visit ◽  
Health Problems ◽  
Primary Care Service ◽  
Patient Portal ◽  
Patient Portals ◽  
Appointment Adherence ◽  
The Impact

BACKGROUND Patient portals are now widely available and increasingly adopted by patients and providers. OBJECTIVE The objective of this study was to investigate the characteristics of primary care patients using different patient portal functions and the impact of patient portal usage on patients’ primary care service utilization and appointment adherence. METHODS A retrospective observational study using a large dataset of primary care patients of University of Florida (UF) Health was conducted. A total of 4312 patient portal users and 17580 nonusers were identified during the study period July 2013 – June 2016. Patients were classified into different user subgroups based on their portal usage of messaging, laboratory, appointment, and medication functions. The association between patient demographics and portal usage were analyzed. Primary care service utilization and appointment adherence were measured by primary care office visits arrived, no-show, cancellation, and telephone encounter rates per quarter. Generalized linear models (GLM) were built to compare the time-dependent portal usage effects across different user subgroups and nonusers. RESULTS Five different user subgroups based on their dominant portal activities and usage frequency were identified. After adopting portals, patients with fewer active health problems used portal infrequently (silent users). Medicare (P = 0.04), White, and age 46-64 (P = 0.01) and 65 and older (P = 0.04) were positively associated with messaging usage. Age 19-30 (P < 0.001) was positively associated with appointment usage, and gender female (P = 0.01) was positively associated with laboratory usage. On the impact of portal usage, disease burden adjusted rate ratios (RR) between user subgroups and nonusers were obtained. The office visit and telephone encounter RRs of users to nonusers were significantly larger than 1 right after portal adoption (with P values less than 0.05), but were not significantly different 2 years after adoption, except for the silent users, whose office visit and telephone encounter rates were significantly smaller after around 1 year post portal adoption (with P values less than 0.05). Office visit cancellation rates were not changed, and no-show rates were significantly reduced or at least not changed post portal adoption. Patients who used messaging and laboratory functions more often exhibited a larger reduction in no-show among other user subgroups. CONCLUSIONS Interestingly, a high propensity to adopt patient portals does not necessarily imply more frequent usage of portals. In particular, the number of active health problems was negatively associated with portal adoption but was positively associated with portal usage. For patients with fewer active health problems, their primary care service utilization was even lower after portal adoption; with a heavy disease burden, the utilization was temporarily increased but was not significantly changed after 2 years post adoption. Overall, appointment adherence was improved after portal adoption.

scholarly journals Growth of Secure Messaging Through a Patient Portal as a Form of Outpatient Interaction across Clinical Specialties

2015 ◽  
Vol 06 (02) ◽  
pp. 288-304 ◽  
Author(s):  
S.E. Davis ◽  
J.A. Shenson ◽  
Q. Chen ◽  
S.T. Rosenbloom ◽  
G.P. Jackson ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Medical Center ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals ◽  
Healthcare Organizations ◽  
Secure Messaging ◽  
Medical Specialties ◽  
Face To Face ◽  
Clinic Visits

SummaryObjective: Patient portals are online applications that allow patients to interact with healthcare organizations. Portal adoption is increasing, and secure messaging between patients and health-care providers is an emerging form of outpatient interaction. Research about portals and messaging has focused on medical specialties. We characterized adoption of secure messaging and the contribution of messaging to outpatient interactions across diverse clinical specialties after broad portal deployment.Methods: This retrospective cohort study at Vanderbilt University Medical Center examined use of patient-initiated secure messages and clinic visits in the three years following full deployment of a patient portal across adult and pediatric specialties. We measured the proportion of outpatient interactions (i.e., messages plus clinic visits) conducted through secure messaging by specialty over time. Generalized estimating equations measured the likelihood of message-based versus clinic outpatient interaction across clinical specialties.Results: Over the study period, 2,422,114 clinic visits occurred, and 82,159 unique portal users initiated 948,428 messages to 1,924 recipients. Medicine participated in the most message exchanges (742,454 messages; 78.3% of all messages sent), followed by surgery (84,001; 8.9%) and obstetrics/gynecology (53,424; 5.6%). The proportion of outpatient interaction through messaging increased from 12.9% in 2008 to 33.0% in 2009 and 39.8% in 2010 (p<0.001). Medicine had the highest proportion of outpatient interaction conducted through messaging in 2008 (23.3% of out-patient interactions in medicine). By 2010, this proportion was highest for obstetrics/gynecology (83.4%), dermatology (71.6%), and medicine (56.7%). Growth in likelihood of message-based interaction was greater for anesthesiology, dermatology, obstetrics/gynecology, pediatrics, and psychiatry than for medicine (p<0.001).Conclusions: This study demonstrates rapid adoption of secure messaging across diverse clinical specialties, with messaging interactions exceeding face-to-face clinic visits for some specialties. As patient portal and secure messaging adoption increase beyond medicine and primary care, research is needed to understand the implications for provider workload and patient care.Citation: Cronin RM, Davis SE, Shenson JA, Chen Q, Rosenbloom ST, Jackson GP. Growth of secure messaging through a patient portal as a form of outpatient interaction across clinical specialties. Appl Clin Inf 2015; 6: 288–304http://dx.doi.org/10.4338/ACI-2014-12-RA-0117

scholarly journals An analysis of patient-provider secure messaging at two Veterans Health Administration medical centers: message content and resolution through secure messaging

2017 ◽  
Vol 24 (5) ◽  
pp. 942-949 ◽  
Author(s):  
Stephanie L Shimada ◽  
Beth Ann Petrakis ◽  
James A Rothendler ◽  
Maryan Zirkle ◽  
Shibei Zhao ◽  
...  
Keyword(s):  
Primary Care ◽  
Further Education ◽  
Patient Portal ◽  
Veterans Health ◽  
Test Results ◽  
Message Content ◽  
Health Administration ◽  
Secure Messaging ◽  
Primary Care Teams ◽  
Reported Data

Abstract Objective: We sought to understand how patients and primary care teams use secure messaging (SM) to communicate with one another by analyzing secure message threads from 2 Department of Veterans Affairs facilities. Methods: We coded 1000 threads of SM communication sampled from 40 primary care teams. Results: Most threads (94.5%) were initiated by patients (90.4%) or caregivers (4.1%); only 5.5% were initiated by primary care team members proactively reaching out to patients. Medication renewals and refills (47.2%), scheduling requests (17.6%), medication issues (12.9%), and health issues (12.7%) were the most common patient-initiated requests, followed by referrals (7.0%), administrative issues (6.5%), test results (5.4%), test issues (5.2%), informing messages (4.9%), comments about the patient portal or SM (4.1%), appreciation (3.9%), self-reported data (2.8%), life issues (1.5%), and complaints (1.5%). Very few messages were clinically urgent (0.7%) or contained other potentially challenging content. Message threads were mostly short (2.7 messages), comprising an average of 1.35 discrete content types. A substantial proportion of issues (24.2%) did not show any evidence of being resolved through SM. Time to response and extent of resolution via SM varied by message content. Proactive SM use by teams varied, but was most often for test results (32.7%), medication-related issues (21.8%), medication renewals (16.4%), or scheduling issues (18.2%). Conclusions: The majority of messages were transactional and initiated by patients or caregivers. Not all content categories were fully addressed over SM. Further education and training for both patients and clinical teams could improve the quality and efficiency of SM communication.

scholarly journals Patient Portals: Objectives, Acceptance, and Effects on Health Outcome – A Scoping Review of Reviews

2021 ◽  
Author(s):  
I. Leb ◽  
S. Magnin ◽  
H.-U. Prokosch ◽  
M. Boeker
Keyword(s):  
Health Outcome ◽  
Scoping Review ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Secure Messaging ◽  
Scoping Reviews ◽  
Prisma Statement ◽  
Review Of Reviews ◽  
Facilitators And Barriers

Patient portals provide patients access to their electronic health record and other functions as secure messaging. For over a decade, more and more patient portals are developed for various settings. The aim of this scoping review of reviews is to systematically search the literature for existing reviews to provide an overview of patient portals’ objectives, acceptance and effects on outcome. We followed the PRISMA Statement and its extension for scoping reviews, and searched for articles published in 2011–2021. The 19 included articles were considerably heterogeneous concentrating on health outcome or patient portal facilitators and barriers.

scholarly journals A Retrospective Analysis of Provider-to-Patient Secure Messages: How Much Are They Increasing, Who Is Doing the Work, and Is the Work Happening After Hours?

10.2196/16521 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16521 ◽  
Author(s):  
Frederick North ◽  
Kristine E Luhman ◽  
Eric A Mallmann ◽  
Toby J Mallmann ◽  
Sidna M Tulledge-Scheitel ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Care Physician ◽  
Work Hours ◽  
Patient Portal ◽  
Secure Messaging ◽  
After Hours ◽  
Over Time

Background Patient portal registration and the use of secure messaging are increasing. However, little is known about how the work of responding to and initiating patient messages is distributed among care team members and how these messages may affect work after hours. Objective This study aimed to examine the growth of secure messages and determine how the work of provider responses to patient-initiated secure messages and provider-initiated secure messages is distributed across care teams and across work and after-work hours. Methods We collected secure messages sent from providers from January 1, 2013, to March 15, 2018, at Mayo Clinic, Rochester, Minnesota, both in response to patient secure messages and provider-initiated secure messages. We examined counts of messages over time, how the work of responding to messages and initiating messages was distributed among health care workers, messages sent per provider, messages per unique patient, and when the work was completed (proportion of messages sent after standard work hours). Results Portal registration for patients having clinic visits increased from 33% to 62%, and increasingly more patients and providers were engaged in messaging. Provider message responses to individual patients increased significantly in both primary care and specialty practices. Message responses per specialty physician provider increased from 15 responses per provider per year to 53 responses per provider per year from 2013 to 2018, resulting in a 253% increase. Primary care physician message responses increased from 153 per provider per year to 322 from 2013 to 2018, resulting in a 110% increase. Physicians, nurse practitioners, physician assistants, and registered nurses, all contributed to the substantial increases in the number of messages sent. Conclusions Provider-sent secure messages at a large health care institution have increased substantially since implementation of secure messaging between patients and providers. The effort of responding to and initiating messages to patients was distributed across multiple provider categories. The percentage of message responses occurring after hours showed little substantial change over time compared with the overall increase in message volume.

scholarly journals Development of an Educational Program to Increase Patient Involvement in a Healthcare Patient Portal: A Quality Improvement Project (Preprint)

2018 ◽  
Author(s):  
Cheryl Stone ◽  
Becky Faett ◽  
Kathy Magdic
Keyword(s):  
Quality Improvement ◽  
Health Care Providers ◽  
Nurse Practitioner ◽  
The United States ◽  
Quality Improvement Project ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals ◽  
Convenience Sample ◽  
Improvement Project

BACKGROUND Efforts in the United States to improve patient engagement and communication with health care providers have led to the creation of the meaningful use program. [1] The Centers for Medicare and Medicaid Services have created a three-stage process to encourage the adoption and use of electronic health records (EHR). Benefits of EHR use include the ability to provide accurate, up-to-date, legible, and complete information about patients at the point of care. One important component of EHR is the patient portal. Patient portals provide 24-hour access to portions of a patient medical record as well as a secure pathway to send messages to providers, ask for refills of medications, and schedule appointments. OBJECTIVE To assess if patients who have not used the patient portal will engage in using the portal after an in-office orientation on how to access and the benefits of using the patient portal. METHODS A quality improvement project was performed using a convenience sample of 60 participants who were scheduled for an appointment in an outpatient cardiology office and had not accessed the patient portal in the past 12 months. The participants were given a survey regarding their computer and internet access as well as their level of comfort using a computer. Each participant was assisted in creating a username and password as well as a security question and answer. The participant then accessed the portal and navigated through the portal with the guidance of the nurse practitioner. They also sent a message via the portal to the provider they were assigned to that day. Each participant was given a pamphlet and a printed power point to reinforce what they had learned. After two months, the nurse practitioner accessed the portal to determine if the enrolled participants had accessed the portal. The reasons for access and frequency were recorded. If there was no access, the participant was called by the nurse practitioner to determine the reason they had not accessed the portal. RESULTS Of the 60 participants, 54% were women, 46% men, 93% were Caucasian. Fifty-six point seven accessed the portal from home. Reasons for access included: 85% reviewed labs, 53% reviewed messages sent to them from the office and 23% sent messages to the office. Twenty-four participants did not access the portal. Of those participants, 33% stated that they had no clear reason to access the portal, 25% stated that they forgot their login information and 17% stated they no interest in the portal. CONCLUSIONS Patient portals are a useful tool for communication between patients and their providers. Providing an in-office orientation to the portal increased patient access to the portal.

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