Online Program

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

Tuesday, November 3, 2015

Mita Goel, MD, MPH, Division of General Internal Medicine & Geriatrics, Northwestern University Feinberg School of Medicine, CHICAGO, IL
Richard Kalu, MD, Division of Internal Medicine, Northwestern University Feinberg School of Medicine, CHICAGO, IL
Matthew Sakumoto, BS, Northwestern University Feinberg School of Medicine, Chicago, IL
Kathryn Jackson, M.S., Center for Health Information Partnerships, Northwestern University Feinberg School of Medicine, Chicago, IL
Sarah Rittner, MA, Alliance of Chicago Community Health Services, Chicago, IL
Timothy Long, MD, Alliance of Chicago Community Health Services, Chicago, IL
Theresa Walunas, Ph.D., Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL

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.


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.


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%).


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.

Learning Areas:

Administer health education strategies, interventions and programs
Communication and informatics
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Public health or related research

Learning Objectives:
Evaluate specific ways to optimize patient portal implementation. Assess the technology profile of patients at one single urban federally qualified health center (FQHC). Describe the access, use of technology among FQHC patients at a single urban setting. Identify facilitators and barriers to technology and patient portal adoption at one urban FQHC. List patient portal features perceived as very important by patients at an urban FQHC. Discuss potential ways of mitigating disparities in use and adoption of a patient portal system among patients in a single urban FQHC setting.

Keyword(s): Health Disparities/Inequities, Information Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have the principal or co-principal involved in federally granted grants focusing on health disparities in technology adoption, specifically electronic communication between patients and their providers. Among my interest has been improving care among vulnerable populations using technology solutions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.