title: An Internet-based patient-provider communication system: randomized controlled trial.
abstract: BACKGROUND
  Internet-based interactive websites for patient communication (patient portals) may improve communication between patients and their clinics and physicians.
  
  
  OBJECTIVE
  The aim of the study was to assess the impact of a patient portal on patients' satisfaction with access to their clinic and clinical care. Another aim was to analyze the content and volume of email messages and telephone calls from patients to their clinic.
  
  
  METHODS
  This was a randomized controlled trial with 606 patients from an academic internal medicine practice. The intervention "portal" group used a patient portal to send secure messages directly to their physicians and to request appointments, prescription refills, and referrals. The control group received usual care. We assessed patient satisfaction at the end of the 6-month trial period and compared the content of telephone and portal communications.
  
  
  RESULTS
  Portal group patients reported improved communication with the clinic (portal: 77/174 [44%] "a little better" or "a lot better;" control: 18/146 [12%]; chi2 = 38.8, df = 1, P < .001) and higher satisfaction with overall care (portal: 103/174 [59%] "very good" or "excellent;" control: 78/162 [48%]; chi2 = 4.1, df = 1, P = .04). Portal group patients also reported higher satisfaction with each of the portal's services. Physicians received 1 portal message per day for every 250 portal patients. Total telephone call volume was not affected. Patients were more likely to send informational and psychosocial messages by portal than by phone. Of all surveyed patients, 162/341 (48%) were willing to pay for online correspondence with their physician. Of those willing to pay, the median amount cited was 2 USD per message.
  
  
  CONCLUSIONS
  Portal group patients demonstrated increased satisfaction with communication and overall care. Patients in the portal group particularly valued the portal's convenience, reduced communication barriers, and direct physician responses. More online messages from patients contained informational and psychosocial content compared to telephone calls, which may enhance the patient-physician relationship.
authors.affiliation: Division of General Internal Medicine, University of Colorado, Health Sciences Center, Denver, CO, USA. CT.Lin@uchsc.edu
authors.forename: Chen-Tan
authors.initials: CT
authors.lastname: Lin
authors.forename: Loretta
authors.initials: L
authors.lastname: Wittevrongel
authors.forename: Laurie
authors.initials: L
authors.lastname: Moore
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Beaty
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Ross
mesh_terms: D003120:Colorado; D004282:Documentation; D006801:Humans; D007255:Information Services; D020407:Internet; D008505:Medical Staff, Hospital; D033283:Patient Access to Records; D017060:Patient Satisfaction; D018579:Patient Selection; D011369:Professional-Patient Relations