title: Improving diabetes management with a patient portal: a qualitative study of diabetes self-management portal.
abstract: BACKGROUND
  Effective management and care of diabetes is crucial to reducing associated risks such as heart disease and kidney failure. With increasing access and use of the Internet, online chronic disease management is being explored as a means of providing patients with support and the necessary tools to monitor and manage their disease.
  
  
  OBJECTIVE
  The objective of our study was to evaluate the experience of patients and providers using an online diabetes management portal for patients.
  
  
  METHODS
  Participants were recruited from a large sample population of 887 for a follow-up questionnaire to be completed after 6 months of using the patient portal. Participants were presented with the option to participate in an additional interview and, if the participant agreed, a time and date was scheduled for the interview. A 5-item, open-ended questionnaire was used to capture providers' opinions of the patient portal. Providers included general practitioners (GPs), nurses, nurse practitioners (NPs), dieticians, diabetes educators (DECs), and other clinical staff.
  
  
  RESULTS
  A total of 854 patients were consented for the questionnaire. Seventeen (8 male, 9 female) patients agreed to participate in a telephone interview. Sixty-four health care providers completed the five open-ended questions; however, an average of 48.2 responses were recorded per question. Four major themes were identified and will be discussed in this paper. These themes have been classified as: facilitators of disease management, barriers to portal use, patient-provider communication and relationship, and recommendations for portal improvements.
  
  
  CONCLUSIONS
  This qualitative study shows that online chronic disease management portals increase patient access to information and engagement in their health care, but improvements in the portal itself may improve usability and reduce attrition. Furthermore, this study identifies a grey area that exists in the roles that GPs and AHPs should play in the facilitation of online disease management.
authors.affiliation: ELLICSR: Health, Wellness & Cancer Survivorship Centre, University Health Network, Toronto, ON, Canada. sara.urowitz@rmp.uhn.on.ca
authors.forename: Sara
authors.initials: S
authors.lastname: Urowitz
authors.forename: David
authors.initials: D
authors.lastname: Wiljer
authors.forename: Kourtney
authors.initials: K
authors.lastname: Dupak
authors.forename: Zachary
authors.initials: Z
authors.lastname: Kuehner
authors.forename: Kevin
authors.initials: K
authors.lastname: Leonard
authors.forename: Emily
authors.initials: E
authors.lastname: Lovrics
authors.forename: Peter
authors.initials: P
authors.lastname: Picton
authors.forename: Emily
authors.initials: E
authors.lastname: Seto
authors.forename: Joe
authors.initials: J
authors.lastname: Cafazzo
mesh_terms: D022126:Access to Information; D001364:Awareness; D003920:Diabetes Mellitus / Q000523:psychology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D012648:Self Care / Q000592:standards*