Patient and Caregiver Expectations for Patient Portal Communication With Providers: Perspectives From an Academic Geriatric Primary Care Practice

BACKGROUND: Electronic patient portals play an increasingly important role in healthcare delivery, facilitating communication between patients and providers. Little is known about how and why older adults and their caregivers use the electronic patient portal and perceive its value. METHODS: We performed a mixed-methods survey-based study of patients and caregivers receiving care in a large academic geriatrics practice to characterize electronic patient portal use in this population. All patients receiving care at the practice with an active patient portal account received a single invitation to complete the survey. Outcomes included patient and caregiver demographics, frequency and expectations for portal communication, and themes of benefits and limitations of portal use. RESULTS: Seven hundred eighty-six of 3850 invitees (20.4%) completed the survey; of these, 683 respondents (86.9%) were patients, and 103 (13.1%) were caregivers. Caregivers reported more frequent messaging than patients, with 12.6% of caregivers sending messages weekly or more compared to 6.1% of patients (p < 0.001). Most patients (54.5%) and caregivers (59.8%) expected responses to messages within 1 business day or faster. Most patients (79.8%) and caregivers (81.6%) felt that the portal improved their care. Positive themes included convenient communication and the ability to avoid in-person care. Negative themes included delayed/inadequate responses to messages and responses from non-physician staff. CONCLUSIONS: Older adults and caregivers frequently use the electronic patient portal, feel it improves their care, and value the convenience and ability to avoid in-person care. Given the perceived value of the portal, interventions to support and optimize portal use to support patients and minimize burdens to clinicians should be a high priority for clinics and health systems.