Objective
To describe the evolution, use, and satisfaction of a patient Web portal with a shared medical record between patients and providers over a 40-month period.
Setting
Group Health Cooperative, a mixed model Health Maintenance Organization based in Seattle, Washington. For enrollees who receive care in the integrated delivery system (IDS), the Web portal, MyGroupHealth (MyGH), provides access to a shared electronic medical record (EMR). For all Group Health enrollees, the portal provides access to medication refills, discussion groups, health assessment tools, and the Healthwise knowledge base.
Methods
A retrospective analysis of content-specific portal use from server logs; random sample mail surveys of portal users in 2002 (N=1,182) and 2004 (N=2,002).
Results
Portal registration increased among all enrollees during study period. As of December 2005, 25% (105,047) had registered and completed an ID-verification process enabling them to use all available services. ID-verification was more common among enrollees receiving care in the IDS (33%) compared to the network (7%). As of December 2005, unique monthly user rates per 1,000 enrollees were the highest for medical test results review (46), medication refills (37), patient-provider clinical messaging (27), and after-visit summary review (27); medical condition review (20), appointment requests (10), immunization review (10), and allergy review (6) were less commonly used. Satisfaction survey response rates were 52% in 2002 (n=612) and 46% in 2004 (n=921). In 2004, 94 % of enrollees were satisfied or very satisfied with MyGH overall. Among individual MyGH services, enrollees reported highest satisfaction (satisfied or very satisfied) for medication refills (96%), patient provider messaging (93%), and medical test results (86%).
Conclusions
Use and satisfaction with the MyGH portal and shared record were greatest for services most actively part of clinical care and patient-provider communication. Tight integration of portal services with clinical care and the EMR may be important in meeting the needs of patients.