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Med Care. 2019 Oct;57(10):809-814. doi: 10.1097/MLR.0000000000001178.

Portal Use Among Patients With Chronic Conditions: Patient-reported Care Experiences.

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Kaiser Permanente Division of Research, Oakland, CA.
University of Tennessee Health Science Center, Memphis, TN.
Mongan Institute of Health Policy, Massachusetts General Hospital, Boston, MA.
Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco.
Kaiser Permanente San Rafael Medical Center, San Rafael, CA.



Personal health records offer patients access to view their own health information and to manage their care online through secure patient portal tools. Little is known about the patient-reported experience in using health portals to manage chronic conditions.


In a patient-centered research study, we examined how using portal tools affects patient health care experiences among patients with chronic conditions. We also examined barriers among nonportal users.


A cross-sectional patient survey.


Patients with a chronic condition in an integrated delivery system offering a patient portal.


Respondents reported barriers, preferences, and experiences in using the patient portal, and whether using the portal changed their overall health.


Among all the 1824 respondents (70% response rate), portal nonusers reported preferring in-person health care (54%) or experiencing internet access barriers (41%). Portal users reported that using the portal was convenient (90%), the information available was useful (92%), and that it integrated well with other health care (92%). Among users, 31% reported that using the portal had improved their overall health. After adjustment, patients were significantly more likely to report that portal use improved their health if they had also reported convenience, information usefulness, or integration with other care (P<0.05). Reassuringly, patient-reported impacts on overall health did not vary by patient characteristics (including age, race, sex, education, income, complex conditions).


Patients with chronic conditions using the portal reported convenience, information usefulness, and integration of the patient portal with their health care; these may act as potential pathways improving health.

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