Table 2.

Opportunities to clarify “rules of engagement” and improve patient-portal use.

Providers’ suggestions	Representative verbatim comment
Offer patient training on appropriate patient-portal use	“One thing that I think might be helpful is to have like almost guidelines for the patient, of what kinds of things are appropriate for MyChart and what kind of things aren’t. So, you know, this is not to discuss new problems or symptoms you are having. That needs to be an office visit. It is to follow up, for quick questions. That kind of thing.”
	“...with training patients and probably providers to some extent too, on how to use it appropriately and transmit the appropriate information.”
Make patients accountable for learning how to use the patient portal	“When they sign up, if we have it written on paper or something like that, that we can hand them and say, ‘Please review these guidelines.’ Maybe have them initial off that they have read them.”
	“Electronically, like have a course. They can take a course, like very brief course. And sign an agreement. And after they sign the agreement, and they understand the application of MyChart, then they would be allowed to sign in for MyChart.”
Enhance secure messaging feature to reinforce “rules”	“I think that when people send refills on MyChart, and I don’t mean the refill mechanism, but they message me with a refill. So it might be good if there was a pop up saying, ‘There is another way to do refills,’ ‘There is another way for emergencies, which is to call on-call,’ ‘There is another way to if it is not about you go to that person’s MyChart.’ So it might be good to have some kind of pop-up, just so they stop and read. It could probably save a lot of nonsense messages.”
	“I think it would be great if it could be filtered, through some system or people. Or some messages need to go to the desk, scheduling person, somewhere. It should go directly to them rather than coming to me and I have to answer and route it to them.”