Table 2.

Participant comments about MyHealthAtVanderbilt (MHAV) and medication management.

Themes and subthemes		Participant quotes
How portal users use MHAV to manage their medications
	Review medication list	It’s really handy to have all that information there—any time you are going to a different doctor that’s outside of Vanderbilt. Because I’m asthmatic and I have like a lot of medications that I only take when necessary—I have a sheet of medications, a full sheet! So it’s nice because when you go to another doctor that doesn’t have access to pull up your medical history, you can go on MyHealth and print it off. So then I can take it with me when I go to a new doctor and [say], “Here, this is what I’m on.” And sometimes it’s helpful for me because I found that the pharmacy—sometimes the milligrams do not match [what’s in MyHealth]. (45-year-old female, Caucasian/white, user)
	Use secure messaging to request prescription reauthorizations	Well, the advantage of doing the little [weekly] pill containers is that when I see that the bottle is getting almost empty, I still have a week’s worth right there in my pill containers, so then I can MyHealth them right away. Cause I’ll look up and go, “I don’t have any refills left this time,” and I MyHealth them right away and ask them to send a prescription to the pharmacy. (46-year-old male, African American/black, user)
Ideas to improve MHAV functionality for medication management and adherence support
	Send proactive refill/reauthorization reminders to providers and patients	So, I think something system-based, that would notify the doctor that, “Hey, unless something has changed in the medical record, you need to—let’s be proactive and have that 90-day [prescription] ready to be called in or sent in or what have you.” Because right now [my pharmacy] has to go back to the doctor’s office and get that. You know, there is a time lag of a couple of days, but I think if it was proactively done through [MHAV], to where it was notifying the doctor and yet also notifying me...that your prescription is ready to be picked up, I think [it] would be really helpful. (46-year-old male, Hispanic, nonuser)
	Automatically send patient-initiated prescription medication fill/refill requests to pharmacies	So you go into MHAV, “I need this refill.” You submit it, and it goes to the pharmacy...And it happens every time, I’m standing out there and I’ll go [to the pharmacy] at 11 and it’s not ready. They close at like 5:30 and I go back at 4. Oh well they haven’t called it in yet. Well we are going to be out, you know, out of medicine. I gotta have insulin for tomorrow...What happens is MHAV will send you a message and say your pharmacy’s been notified of this refill. [Then] when you [go] to the pharmacy, the pharmacist will argue with you and you’ll be like, “You don’t have the medication?” and sometimes that’s a two to three day deal getting this medication. (42-year-old female, Caucasian/white, user)
	Allow patients to request refills and/or reauthorizations for multiple medications at once	That’s one of the things that MHAV could do different is to have a link to the pharmacy. So you go in [to MHAV], I need this refill, you check it, submit it and it goes to the pharmacy...you go in [to MHAV] and it says renew/refill prescriptions and you check the box, say I need medicine A and B and you just check A and B. Prescriptions are already on file. I hit submit and it automatically goes to the pharmacy. (45-year-old male, Caucasian/white, user)
	Alert providers to patients’ fill/refill nonadherence	I think [linking MHAV and the pharmacy] would help. [If] you get a prescription filled for a 90-day supply of Metformin and then 100 days go by and you haven’t called for your refill then something is up. You’ve either been noncompliant and you have way too many pills left or you’re dead, or you’re in the hospital or something has happened, you know. The pharmacy here doesn’t call me and say, “You know what? It’s been 100 days since you refilled your Metformin.” And I’m thinking, like...I’m sure [another company] would call you to find out, “What’s going on? You haven’t gotten your refill lately.” (58-year-old female ,Caucasian/white, user)
	Help patients understand and manage medication side effects	I should be able to go on MHAV and put in Verapamil and pull it up and it tells me, “This is what Verapamil is, what it’s prescribed for, if you start noticing these symptoms, tell your doctor.” When you change pills, you don’t know what is what because you take [a] whole bunch of pills every day...If there were links [on MHAV] where I could have clicked on that medicine and it said, “These are the common side effects. If you have any of these...” Or tell me, “This cough is going to go away in two weeks,” or, “This cough is never going to go away—call your provider.” (42-year-old female, Caucasian/white, user)
	Help patients understand and avoid medication interactions	If I could go into my record...be able to go in there somehow and see all the meds I’m on and have something say, “These meds all work together great,” or, “By taking these three different kinds of medicines you might have [an interaction].” And right now, that’s not available to me. I don’t know [that] unless I sit down with my doctor. If my other doctor puts something on [my medication list], [it’s important] that somehow we know that all these drugs are okay together. (46-year-old male, Hispanic, nonuser)