Barriers and Facilitators to Online Portal Use Among Patients and Caregivers in a Safety Net Health Care System: A Qualitative Study

• DOI: 10.2196/jmir.4847
• Publication Date: 2015-12-03T11:00:25Z
• Authors: Lina Tieu; Urmimala Sarkar; Dean Schillinger; James D Ralston; Neda Ratanawongsa; Rena Pasick; Courtney R Lyles
• Keywords: Patient portal; Safety net; Health Literacy

Background: Patient portals have the potential to support self-management for chronic diseases and improve health outcomes. With rapid rise in adoption of patient spurred by meaningful use incentives among safety net systems (a system or hospital providing a significant level care low-income, uninsured, vulnerable populations), it is important understand readiness willingness patients caregivers settings access their personal records online. Objective: To explore caregiver perspectives on online portal before its implementation at San Francisco General Hospital, hospital. Methods: We conducted 16 in-depth interviews with disease who expressed interest using Internet manage health. Discussions focused experiences, technology use, an tasks. used open coding categorize all barriers facilitators followed second round that compared categories previously published findings. In secondary analyses, we also examined specific 2 subgroups: those limited literacy caregivers. Results: interviewed 11 5 Patients were predominantly male (82%, 9/11) African American (45%, 5/11). All had been diagnosed diabetes majority (73%, 8/11). The female (80%, 4/5), (60%, 3/5), individuals adequate 3/5). A total 88% (14/16) participants reported after viewing prototype. Major perceived included security concerns, lack technical skills/interest, preference in-person communication. Facilitators convenience, monitoring, improvements patient-provider Participants discussed more fundamental including challenges reading typing, experience breaches/viruses, distrust measures. Caregivers high roles interpreting information, advocating quality care, managing behaviors medical care. Conclusions: Despite concerns about security, difficulty understanding satisfaction current communication processes, respondents generally enthusiasm use. Our findings suggest strong need training assist registration particularly literacy. Efforts encourage should directly address security/privacy issues