Patient Portal Implementation in a Federally Qualified Community Health Center (FQHC): Patient-reported Facilitators and Barriers

Introduction:

Patient portals support federal incentive guidelines by strengthening the meaningful use of electronic health records and allowing patients to communicate securely with providers, review test results and request medication refills.  While meant to increase patient engagement, significant disparities in patient enrollment in the portal have been noted.  This study aims to optimize patient portal implementation in an FQHC by better understanding use of, and attitudes towards, technology among their patients.

Methods:

We conducted an in-person survey among a convenience sample of 149 participants at one urban FQHC prior to a patient portal implementation. We assessed patients’ Internet access and perceptions of using a patient portal for health management.

Results:

The mean age was 46 years old; 93% were African American and 61% were women.  92.6% of respondents stated they have access to the Internet; 54% exclusively via home computer and 30% exclusively via mobile phone. Mobile device ownership was also very high (98%) with a significant majority using their phone to access the internet (89%). Patient portal features rated as very important were: viewing test results (74%), requesting medication refills (73%) and scheduling appointments (68%). In contrast, 15% rated sharing medical records with family members as very important.  Perceived barriers to using patient portals included concerns around ease of use of the portal (51%) and security of health information (29%).

Conclusion:

In this single site FQHC, access to the Internet and positive perceptions toward the patient portal were high; however, patients reported significant concerns about usability and security. Achieving meaningful use and preventing worsening of disparities in patient portal uptake requires attention to specific barriers and facilitators.