title: Implementing and Using a Patient Portal: A qualitative exploration of patient and provider perspectives on engaging patients.
abstract: The use of portals might be expected to rise; however, adoption has been slow. Development of portals has occurred with limited patient involvement. This paper fills a need for literature concerning perspectives regarding the value of portals, how best to organize and provide portals, and critically how to seek patient involvement in implementation.ObjectiveThe objective was to explore the feelings, ideas, and expectations of patients and primary care providers concerning the implementation and use of patient portals.
  
  
  
  The study employed a descriptive qualitative design interviewing seven patients and four providers from an interdisciplinary primary health care clinic in Ontario, Canada. Patients were older with at least one chronic condition. Interviews were analysed independently by three coders who then met to synthesize the findings.
  
  
  
  There was limited experience of portals and substantial convergence between patients and providers regarding concerns and potential benefits with an overall positive view. Four themes emerged: 1) the Context in which patient portal use takes place; 2) the Necessary conditions for use of a patient portal; 3) the Implementation of a patient portal; and 4) the Use of a patient portal for care.
  
  
  
  Findings highlight that it is not sufficient to engage patients in the use of a portal; it is critical that patients be engaged in the early stages of implementation. With many health and fitness electronic tools available (e.g. Fitbit©), this study remind us that tools are not enough. Patient engagement requires patient-centred partnerships between patients and health care providers.
authors.affiliation: Schulich School of Medicine & Dentistry, Western University. bryan@uwo.ca.
authors.forename: Bridget L
authors.initials: BL
authors.lastname: Ryan
authors.affiliation: Schulich School of Medicine & Dentistry, Western University. Judith.Brown@schulich.uwo.ca.
authors.forename: Judith Belle
authors.initials: JB
authors.lastname: Brown
authors.affiliation: Schulich School of Medicine & Dentistry, Western University. Amanda.Terry@schulich.uwo.ca.
authors.forename: Amanda
authors.initials: A
authors.lastname: Terry
authors.affiliation: Schulich School of Medicine & Dentistry, Western University. scejic@uwo.ca.
authors.forename: Sonny
authors.initials: S
authors.lastname: Cejic
authors.affiliation: Schulich School of Medicine & Dentistry, Western University. moira@uwo.ca.
authors.forename: Moira
authors.initials: M
authors.lastname: Stewart
authors.affiliation: Schulich School of Medicine & Dentistry, Western University. athind2@uwo.ca.
authors.forename: Amardeep
authors.initials: A
authors.lastname: Thind
mesh_terms: D022126:Access to Information; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000379:methods*; D057286:Electronic Health Records; D066275:Health Information Exchange; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D009864:Ontario; D010342:Patient Acceptance of Health Care; D033283:Patient Access to Records; D010358:Patient Participation / Q000523:psychology*; D000072638:Patient Portals; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research
keywords: personal health records; professional-patient relations, primary health care