Background/Purpose: During natural disasters, the healthcare needs of patients rise while available resources become limited. Patient portals have important roles in improving patient engagement in healthcare and reducing unnecessary visits and costs. This study aims to examine patients’ health needs during a time of natural crisis by analyzing electronic messages of patients to providers via patient portals during the Hurricane Harvey event in 2017.

Methods: Qualitative methodology was used to examine the electronic communication between patients and providers during Hurricane Harvey. We used the constant comparative methodological approach in coding the communications, which enabled the research team to explore emergent themes. Two members coded the messages, and the team discussed any inconsistencies for the consensus. Coding of themes was partially based on established patient-provider communication coding systems.

Results/Outcomes: A total of 3,735 individual messages sent by 2,007 unique patients between August 27, 2017 and August 31, 2017 was identified for the analysis. The messages were categorized into four major themes and 14 sub-themes: 1) Appointment (Confirmation, Reschedule, Cancellation), 2) Access (Physical facility, Communication, Lap work, Transportation, Drugs-unfulfilled), 3) Concerns/Advice (Health status concerns, concerns for provider, Advice), and 4) Prescription refills (Normal prescription refill request, Emergency prescription refill request, Prescription issue/questions).

Conclusions: This study revealed the medical needs of patients during Hurricane Harvey, indicating what types of demands may arise in future disaster situations. This information can serve as the first step in intentionally optimizing patient portals usability for emergency situations.