What do we know about developing patient portals? a systematic literature review.
OBJECTIVE
Numerous articles have reported on the development of patient portals, including development problems and solutions. We review these articles to inform future patient portal development efforts and to provide a summary of the evidence base that can guide future research.


METHODS
We performed a systematic review of relevant literature to answer 5 questions: (1) What categories of problems related to patient portal development have been defined? (2) What causal factors have been identified by problem analysis and diagnosis? (3) What solutions have been proposed to ameliorate these causal factors? (4) Which proposed solutions have been implemented and in which organizational contexts? (5) Have implemented solutions been evaluated and what learning has been generated? Through searches on PubMed, ScienceDirect and LISTA, we included 109 articles.


RESULTS
We identified 5 main problem categories: achieving patient engagement, provider engagement, appropriate data governance, security and interoperability, and a sustainable business model. Further, we identified key factors contributing to these problems as well as solutions proposed to ameliorate them. While about half (45) of the 109 articles proposed solutions, fewer than half of these solutions (18) were implemented, and even fewer (5) were evaluated to generate learning about their effects.


CONCLUSIONS
Few studies systematically report on the patient portal development processes. As a result, the review does not provide an evidence base for portal development.


CONCLUSIONS
Our findings support a set of recommendations for advancement of the evidence base: future research should build on existing evidence, draw on principles from design sciences conveyed in the problem-solving cycle, and seek to produce evidence within various different organizational contexts.
Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands ottetrojel@bmg.eur.nl ottetrojel@berkeley.edu.
Terese
T
Otte-Trojel
Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands.
Antoinette
A
de Bont
School of Public Health, University of California Berkeley, Berkeley, California, USA.
Thomas G
TG
Rundall
Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands.
Joris
J
van de Klundert
D057286:Electronic Health Records / Q000706:statistics & numerical data; D055991:Health Records, Personal; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data
design and development; design sciences; patient portals; personal health records; systematic review