title: Primary Care Providers' Views of Patient Portals: Interview Study of Perceived Benefits and Consequences.
abstract: BACKGROUND
  The United States government is encouraging physicians to adopt patient portals-secure websites that allow patients to access their health information. For patient portals to recognize their full potential and improve patient care, health care providers' acceptance and encouragement of their use will be essential. However, little is known about provider concerns or views of patient portals.
  
  
  OBJECTIVE
  We conducted this qualitative study to determine how administrators, clinic staff, and health care providers at practices serving a lower income adult population viewed patient portals in terms of their potential benefit, areas of concern, and hopes for the future.
  
  
  METHODS
  We performed in-depth interviews between October 2013 and June 2014 with 20 clinic personnel recruited from health centers in four North Carolina counties. Trained study personnel conducted individual interviews following an interviewer guide to elicit perceptions of the benefits and disadvantages of patient portals. Interviews were recorded and transcribed. Research team members reviewed transcribed interviews for major themes to construct a coding dictionary. Two researchers then coded each transcript with any coding discrepancies resolved through discussion.
  
  
  RESULTS
  The interviews revealed that clinic personnel viewed patient portals as a mandated product that had potential to improve communication and enhance information sharing. However, they expressed many concerns including portals' potential to generate more work, confuse patients, alienate non-users, and increase health disparities. Clinic personnel expected few older and disadvantaged patients to use a portal.
  
  
  CONCLUSIONS
  Given that clinic personnel have significant concerns about portals' unintended consequences, their uptake and impact on care may be limited. Future studies should examine ways portals can be implemented in practices to address providers' concerns and meet the needs of vulnerable populations.
authors.affiliation: Wake Forest School of Medicine, Department of Internal Medicine, Winston-Salem, NC, United States. dmiller@wakehealth.edu.
authors.forename: David P
authors.identifier: http://orcid.org/0000-0001-7879-4427
authors.initials: DP
authors.lastname: Miller
authors.forename: Celine
authors.identifier: http://orcid.org/0000-0002-2132-0092
authors.initials: C
authors.lastname: Latulipe
authors.forename: Kathryn A
authors.identifier: http://orcid.org/0000-0002-7858-5032
authors.initials: KA
authors.lastname: Melius
authors.forename: Sara A
authors.identifier: http://orcid.org/0000-0002-2968-5459
authors.initials: SA
authors.lastname: Quandt
authors.forename: Thomas A
authors.identifier: http://orcid.org/0000-0001-9523-9492
authors.initials: TA
authors.lastname: Arcury
mesh_terms: D022126:Access to Information; D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D017598:Efficiency, Organizational; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research
keywords: attitude; personal health records; primary health care; vulnerable populations