Table 1.

Comparison of patient portals and health apps on eight socio-technical dimensions.

Dimension	Patient Portals	Health Applications
Hardware and Software	Accessible via computers, smart phones, and tablets Data is entered in system by labs and physicians	Accessible via computers, smart phones, and tablets Data is entered by consumers and imported via tracking devices
Clinical Content	Patients can access their personal health information (i.e., test results, immunizations) Direct Messaging with physician and health care team Contain medical terminology and acronyms that are unfamiliar to most patients40	Consumers can enter health information Data taken/entered in real-time Data is taken in from the tracking devices (i.e., the accelerometer in the iPhone) Generally no access to test results from physician No communication access to physician or health care team
Human-Computer Interface	Accessible from the web and smartphones Information is not always displayed in an understandable way, specifically test results Outdated user interface design	Simple to access, use, and navigate Information is often displayed in a way consumers without comprehensive medical knowledge can understand Up-to-date, simple user interface design
People	Aim to connect patients to information from health care system	Consumers can often connect and compete with other patients
Workflow and Communication	Patients sign up through their doctor’s office Patient password reset issues (e.g., in recent interviews, patients have complained about being “locked” out of their portal)	Consumers download the app and create their own account Consumers’ activities are passively tracked, reducing data entry Consumers have easy access to their data anytime, anywhere
Internal organizational policies, procedures, culture, and environment	Subject to an organization’s internal policies and procedures, which often create barriers to use (e.g., difficult sign-up procedures; reluctance of clinicians to participate in un-compensated work)	Currently subject to very little internal or external oversight (e.g., App developers can “sell” patient data) Culture is “move fast, fix problems later” Some have been found to sacrifice quality or safety in the pursuit of functionality22
External Rules, Regulations, Pressures	Must be HIPAA compliant Must meet the legal and confidentiality needs of adolescents41	HIPAA compliance under review Accessible to anyone with a smartphone Constantly evolving smartphone operating system requirements
System Measurement and Monitoring	Few organizations monitor or measure how patient portal information is being used Lack of real-time notifications and alerts to patients	Consumers use apps to monitor their own health Depending on the app, different alerts are sent to the consumer’s phone