title: Interest in the use of computerized patient portals: role of the provider-patient relationship.
abstract: BACKGROUND
  Bioinformatics experts are developing interactive patient portals to help those living with diabetes and other chronic diseases to better manage their conditions. However, little is known about what influences patients' desires to use this technology.
  
  
  OBJECTIVE
  To discern the impact of the provider-patient relationship on interest in using a web-based patient portal.
  
  
  METHODS
  Qualitative analysis of focus groups.
  
  
  METHODS
  Ten focus groups involving 39 patients (range 2-7) recruited from four primary care practices.
  
  
  METHODS
  A qualitative approach was used, which involved reading transcribed texts until a consensus was reached on data interpretation. An intercoder reliability kappa score (0.89) was determined by comparing the provider-patient relationship talk selected by the two coders. A conceptual framework was developed, which involved the development and refinement of a codebook and the application of it to the transcripts.
  
  
  RESULTS
  Interest in the portal was linked to dissatisfaction with the provider-patient relationship, including dissatisfaction with provider communication/responsiveness, the inability to obtain medical information, and logistical problems with the office. Disinterest in the portal was linked to satisfaction with the provider-patient relationship, including provider communication/responsiveness, difficulty in using the portal, and fear of losing relationships and e-mail contact with the provider. No patient identified encrypted e-mail communication through the portal as an advantage.
  
  
  CONCLUSIONS
  Promoting the use of computerized portals requires patient-based adaptations. These should include ease of use, direct provider e-mail, and reassurances that access and interpersonal relationships will not be lost. Education is needed about privacy concerns regarding traditional e-mail communication.
authors: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, 151C-U, University Drive C, Pittsburgh, PA 15240, USA. Susan.Zickmund@med.va.gov
authors: Susan L
authors: SL
authors: Zickmund
authors: Rachel
authors: R
authors: Hess
authors: Cindy L
authors: CL
authors: Bryce
authors: Kathleen
authors: K
authors: McTigue
authors: Ellen
authors: E
authors: Olshansky
authors: Katharine
authors: K
authors: Fitzgerald
authors: Gary S
authors: GS
authors: Fischer
mesh_terms: D000328:Adult; D001292:Attitude to Computers; D002908:Chronic Disease; D003142:Communication; D019295:Computational Biology; D003920:Diabetes Mellitus / Q000628:therapy*; D034742:Electronic Mail / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006302:Health Services Research; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D033283:Patient Access to Records; D010865:Pilot Projects; D011320:Primary Health Care / Q000592:standards / Q000639:trends; D011336:Probability; D011369:Professional-Patient Relations; D012680:Sensitivity and Specificity