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Although patient portals are widely used for health promotion, little is known about the use of palliative care and end-of-life (PCEOL) portal tools available for patients and caregivers.
This study aims to identify and assess the user perspectives of PCEOL portal tools available to patients and caregivers described and evaluated in the literature.
We performed a scoping review of the academic literature directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) extension for Scoping Review and searched three databases. Sources were included if they reported the development or testing of a feature, resource, tool, or intervention; focused on at least one PCEOL domain defined by the National Coalition for Hospice and Palliative Care; targeted adults with serious illness or caregivers; and were offered via a patient portal tethered to an electronic medical record. We independently screened the titles and abstracts (n=796) for eligibility. Full-text (84/796, 10.6%) sources were reviewed. We abstracted descriptions of the portal tool name, content, targeted population, and reported user acceptability for each tool from included sources (n=19).
In total, 19 articles describing 12 tools were included, addressing the following PCEOL domains: ethical or legal (n=5), physical (n=5), and psychological or psychiatric (n=2). No tools for bereavement or hospice care were identified. Studies have reported high acceptability of tools among users; however, few sources commented on usability among older adults.
PCEOL patient portal tools are understudied. As medical care increasingly moves toward virtual platforms, future research should investigate the usability and acceptability of PCEOL patient portal resources and evaluate their impact on health outcomes.
Patient portals are secure websites that provide access to personal health information and health care services that often include web-based tools for medical visits, health records, and medications [
Patients with chronic or serious illness may especially benefit from access to patient portals; in fact, having a chronic illness is a predictor of portal enrollment and use [
In light of the potential benefits of digital health technologies for older adults and individuals with chronic or serious illness, interest is also growing in digital health interventions targeted toward palliative care and end-of-life (PCEOL) patients, including the use of patient portals [
As a first step in this line of research, we aim to conduct a scoping review of PCEOL patient portal research. The aims of this study are to (1) identify PCEOL patient portal tools available for patients and caregivers that are described and evaluated in the literature and (2) document patient and caregiver perspectives regarding these tools. By describing currently available tools and their respective user perspectives, this review intends to inform future research examining the association between tool use and PCEOL outcomes while guiding future PCEOL patient portal tool development.
As little is known about the use of patient portals for the delivery of palliative and end-of-life care, a scoping review of the academic literature was conducted to identify sources describing currently available patient portal PCEOL tools. Our methods were aligned with methodological framework for scoping reviews by Arksey and O’Malley [
To identify PCEOL patient portal tools described in the academic literature, we searched three databases (Ovid MEDLINE, CINAHL, and Web of Science) for peer-reviewed sources, including both qualitative and quantitative studies. The search terms included
Sources were included in the scoping review if they (1) described a developed feature, resource, tool, or intervention that focused on at least one domain of PCEOL as defined by the National Coalition for Hospice and Palliative Care [
Physical aspects of care including pain and symptom management, as well as quality of life assessment
Psychological aspects of care, including care about anxiety, depression, stress, cognitive impairment, psychosocial support, coping skills, and support around patient or family grief and bereavement
Social aspects of care, including patient and family education and caregiver support
Spiritual and cultural aspects of care, including spiritual, existential, or religious support or attention to language, ritual, or dietary needs
Care of the imminently dying, including end-of-life care and education
Ethical and legal aspects of care, including ACP and documentation (appointment of MDPOA or health care proxy, and completion of advance directives)
To determine whether sources met the inclusion criteria, 2 coders (MPI and CV) independently reviewed the academic sources by title and abstract.
Full texts of sources included by title and abstract were downloaded and further assessed for eligibility by 2 coders (MPI and CV). We determined whether the portal tool was targeted toward patients, caregivers, or both by reviewing the full text of the included sources for explicit mention of the intended users of the portal tool. The full text was also reviewed for a thorough description of the tool’s purpose and available features, apps, and content. Sources that presented a protocol or planned portal feature, did not provide a detailed description of the resources or content (eg, abstract and review articles), did not focus on a PCEOL domain, targeted a pediatric or non–seriously ill population, examined the user characteristics and perspectives of general portal use, were not published in English, described a tool that was not tethered to a patient portal (eg, free-standing website or mobile app), or for which the full text was not retrievable, were excluded from the review. Pediatric populations were excluded because of their different care needs, access to technology, and technological skills.
The coders regularly reviewed the sources and discussed questions and possible disputes. Both coders agreed on the features included in the review, with a third reviewer (JDP) reconciling disputes. A summary of the search and screening processes is shown in
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. PCEOL: palliative care and end-of-life.
The full text of each of the included sources was reviewed, and the elements and features of the described PCEOL patient portal tool were abstracted by 2 reviewers (MPI and CV) into a Microsoft Excel spreadsheet. To ensure consistency, the reviewers double-extracted five articles before dividing the remaining articles. The abstracted data included the following components: portal name, health system user, developer (research team or organization), target illness and/or palliative care element, intended audience (patient, patient’s caregiver, or both), and a summary of the features. When described, patient and caregiver perspectives about the tool, including measurements and qualitative reports of acceptability or usability and user satisfaction, were abstracted.
We used an iterative and mixed inductive-deductive approach to summarize the charted information and results from the included papers to address our aims [
The initial database search identified 796 unique sources that we screened by title and abstract (
We abstracted data from 19 sources published between the years 2013 and 2020 that describe 12 unique PCEOL patient portal tools (
Summary of included articles.
Study | Portal name | PCEOLa domain | Sample size and characteristics | Study design | Developer | Summary of features | Summary of portal use | Promotion of use |
Bajracharya et al [ |
PatientSite | Ethical or legal (ACPb) | 200 patients; 63% women; 82% White; mean age 55 years (SD 15.16) | Evaluation of portal implementation | Beth Israel Deaconess Medical Center, Boston, MA, United States | A guided HCPc interview delivered via patient portal that provides education on the HCP role, collects information necessary for the completion of an HCP form, allows patients to print the HCP form and submit their HCP form electronically. The HCP form may be incorporated into patient’s personal health record. | Of the participants that did not have an HCP listed before partaking in the interview, 78% submitted HCP information for clinician review. Of 200 patients, 139 submitted updated or new information about HCP overall. | N/Ad |
Tieu et al [ |
Mayo Clinic Patient Online Services | Ethical or legal (ACP) | 2526 patients; 51% female; mean age 72 years (SD 5.8) | Randomized controlled intervention | Mayo Clinic, Rochester, MN, United States | Tool delivers a personalized, electronic message to patients with a link to ACP education and a state-specific advance directive form. | Only 5.5% of the intervention group and 2% of the control group completed and returned an ADe. | Patients randomized to intervention group received message encouraging them to complete AD; reminder was sent out 8 weeks after if patients had not completed. |
Bose-Brill et al [ |
MyChart (operated through Epic) | Ethical or legal (ACP) | 50 patients | Randomized controlled pilot intervention | The Ohio State University, Columbus, OH, United States | Tool delivers a secure message to patients consisting of an introduction to ACP and four ACP-related questions. The responses are automatically stored in the patient’s medical record and integrated into an ACP previsit planning algorithm focused on enhancing patient-provider communication surrounding ACP preferences. | In the intervention group, 10 of 23 participants completed ACP documentation compared with 1 of 25 participants in the control group. | N/A |
Bose-Brill et al [ |
MyChart (operated through Epic) | Ethical or legal (ACP) | 419 patients; 65% female; median age 61 years; range 50-93 | Pragmatic trial | The Ohio State University, Columbus, OH, United States | Tool delivers a secure message to patients consisting of an introduction to ACP and four ACP-related questions. The responses are automatically stored in the patient’s medical record and integrated into an ACP previsit planning algorithm focused on enhancing patient-provider communication surrounding ACP preferences. | ACP documentation in EHRf increased by 27% in intervention group, compared with 0.7% in control group. 78% of the intervention group read the initial message sent to them and 19% responded to at least one ACP-related question. | N/A |
Lum et al [ |
MyHealth Connection (operated through Epic) | Ethical or legal (ACP) | 2184 patients; 69% female; mean age 45 years; range 17-98 | Quality improvement intervention | University of Colorado Hospital, Aurora, CO, United States | Tool provides patient-centered website for ACP education, secure messaging with an ACP support team, the ability to complete and sign an MDPOAg form and to view the completed advance directive in the patient’s personal health record. | Over 15 months, 2814 patients used ACP tool; 89% completed MDPOA form, 2% called or sent web-based messages; 8% viewed MDPOA form without completing. | N/A |
Jordan et al [ |
MyHealth Connection (operated through Epic) | Ethical or legal (ACP) | 46 patients; 63% female; mean age 49 years | Exploratory qualitative study | University of Colorado Hospital, Aurora, CO, United States | Tool provides patient-centered website for ACP education, secure messaging with an ACP support team, the ability to complete and sign an MDPOA form and to view the completed advance directive in the patient’s personal health record. | Not collected | N/A |
Brungardt et al [ |
MyHealth Connection (operated through Epic) | Ethical or legal (ACP) | 105 older adult patients | Practice-based pilot initiative | University of Colorado Hospital, Aurora, CO, United States | Tool provides patient-centered website for ACP education, secure messaging with an ACP support team, the ability to complete and sign an MDPOA form and to view the completed advance directive in the patient’s personal health record. | At 1 year, 63 patients read ACP message and 17 had taken at least one ACP action step. | N/A |
Portz et al [ |
My Health Manager (operated through Epic) | Ethical or legal (ACP) | 24 older adult patients with multiple chronic conditions; 71% female; 79% White; mean age 78 years (SD 5.4) | Qualitative case study | Kaiser Permanente, Denver, CO, United States | Tool provides ACP education, ACP resources, and links to external website to complete advance directives. | Not collected | N/A |
Dalal et al [ |
Patient-Centered Toolkit | Physical (QOLh) | 119 admitted patients and 120 caregivers; 43% female; mean age 56 years | Evaluation of portal implementation | Brigham and Women’s Hospital, Boston, MA, United States | Tool allows patients with serious illness to navigate their plan of care during hospitalization. Patient can establish a single recovery goal and rate priorities, review medication and test results, securely message their care team, access educational content, and view discharge checklists, tailored safety tips, and reminders. | 66% users inputted daily goal; 41% inputted overall goal (to be cured, to live longer, to be comfortable, other); 32% communicated care preferences; 64% provided real-time feedback for team. Goals, results, team members, medications, and messages were the most frequently visited pages. Problem education was the least frequently visited page. | N/A |
Dalal et al [ |
Patient-Centered Toolkit | Physical (QOL) | 55 patients preintervention, 40% female, 89% White; mean age 59 years (SD 12.8); 46 patients postintervention, 46% female, 83% White, mean age 58 years (SD 13.5) | Prospective pre- or postintervention study | Brigham and Women’s Hospital, Boston, MA, United States | Tool allows patients with serious illness to navigate their plan of care during hospitalization. Patient can establish a single recovery goal and rate priorities, review medication and test results, securely message their care team, access educational content, and view discharge checklists, tailored safety tips, and reminders. | Not collected | Participants were encouraged to enter recovery goals to the portal. |
Kuijpers et al [ |
MyAVL or MijnAVL | Physical (QOL) | 92 female patients with breast cancer; mean age 49 years (SD 11.4) | Pre- or posttest intervention | Netherlands Cancer Institute, Amsterdam, Netherlands | PROi collection and symptom management for patients with breast or non–small cell lung cancer. Patients can complete quality of life and physical activity questionnaires and receive personalized physical activity advice based on the questionnaire responses. | Overview of appointments and EMRj were accessed most frequently; mean number of log-ins for on-treatment is 10.9 with mean of 11.3 minutes. Mean number of log-ins for off-treatment is 5.6 with mean of 15.2 minutes. | N/A |
Groen et al [ |
MyAVL (MijnAVL) | Physical (QOL) | 37 patients with lung cancer; 47% women; 100% White; mean age 59 years (SD 8.4); range 40-76 years | Feasibility intervention | Netherlands Cancer Institute, Amsterdam, Netherlands | PRO collection and symptom management for patients with breast or non–small cell lung cancer. Patients can complete quality of life and physical activity questionnaires and receive personalized physical activity advice based on the questionnaire responses. | Mean number of log-ins over 4-month study period—11.2 with mean duration of 12.9 minutes. Overview of appointments, access to EMR, and questionnaires were the most accessed. | N/A |
Wagner et al [ |
MyChart (operated through Epic) | Physical (QOL) | 636 female patients with cancer; 78% White; age mean 55 years (SD 12.8); range 21-90 years | Clinical quality improvement initiative | PROMISk, Northwestern University (Chicago, IL) and US Department of Health and Human Services (Washington, DC), United States | PRO collection and symptom management for patients with cancer. Delivers electronic PRO assessments and other assessments to identify psychosocial concerns, informational and nutritional needs. The results are immediately populated to the patient’s EHR. This integration allows automated triage to multidisciplinary care team. | 80% of patients read the initial MyChart message asking for e-PROl assessment completion; about 33% completed the entire assessment. 90% of the patients that completed the assessment did so at home. | e-PRO assessments were sent before scheduled outpatient appointments through MyChart. Those who did not compete the assessment at home were provided with an iPad to complete the assessment during appointment check-in. |
Garcia et al [ |
MyChart (operated through Epic) | Physical (QOL) | 3521 patients with cancer; 68% female; 76% White; mean age 57 years (SD 13.39) | Clinical quality improvement initiative | PROMIS, Northwestern University (Chicago, IL) and US Department of Health and Human Services (Washington, DC), United States | PRO collection and symptom management for patients with cancer. Delivers electronic PRO assessments and other assessments to identify psychosocial concerns, informational and nutritional needs. The results are immediately populated to the patient’s EHR. This integration allows automated triage to multidisciplinary care team. | Not collected | e-PRO assessments were sent before scheduled outpatient appointments through MyChart. Those who did not compete the assessment at home were provided with an iPad to complete the assessment during appointment check-in. |
Brant et al [ |
Carevive Care Planning System | Physical (QOL) | 121 female patients with gynecologic or breast cancer; 83% White; age mean 56 years (SD 10.94); range 28-81 | Mixed methods pilot study | Carevive, United States | PRO collection and symptoms management for patients with breast or gynecologic cancer. Collects PRO and integrates responses and clinical data to create a tailored care plan that provides clinical decision support and self-management advice to patient and caregivers. | Not collected | N/A |
Hazara et al [ |
Renal PatientView | Physical (QOL) | 190 patients with chronic kidney disease; 34% female; median age 53 years; range 19-86 | Quality improvement initiative | Renal Patient Exchange Group, United Kingdom | PRO collection and symptom management for patients with chronic kidney disease. Patients can document and monitor symptoms and other health indicators and access educational resources. | Between 2009-2013, tool had 421 registered users and 54% were active. | N/A |
Hudson et al [ |
Renal PatientView | Physical (QOL) | 10 patients with chronic kidney disease; 20% female; age mean 59 years | Ethnographic qualitative study | Renal Patient Exchange Group, United Kingdom | PRO collection and symptom management for patients with chronic kidney disease. Patients can document and monitor symptoms and other health indicators and access educational resources. | Not collected | N/A |
Pai et al [ |
Provider | Psychological or psychiatric | 22 male patients with prostate cancer; 95% White; mean age 64 years (51-76) | Nonexperimental posttest only | British Columbia Cancer Agency and the School of Health Information Science at the University of Victoria, Victoria, BC, Canada | Psychosocial support for patients with prostate cancer. Allows patients to view a summary of prostate cancer diagnosis, cancer treatment received, and monitor health indicators. Patients can also access a treatment decision support tool, a questionnaire on distress level, education on prostate cancer and its treatments, and a tailored clinical trial and research screening tool. | Mean registered log-ins over 6 months was 3.4. Medical records, appointment viewer, and PSAm monitoring tool were accessed most frequently by users. | N/A |
Nahm et al [ |
CaS-PETn | Psychological or psychiatric | 30 patients with cancer; 77% female; 33% White; mean age 56 years (SD 13.6) | One group pre- or posttest pilot study | University of Maryland Medical Center, Baltimore, MD, United States | Psychosocial support for patients with cancer. Provides 12-week content with six modules including transition to survivorship, nutrition, exercise, cancer and relationships, fear and mental health, and stress management using mindfulness. There are goal setting activities, discussion boards, and virtual libraries at the end of each module. | Not collected | Biweekly follow-up messages were sent out after initial message. |
aPCEOL: palliative care and end-of-life.
bACP: advance care planning.
cHCP: health care proxy.
dN/A: not applicable.
eAD: advance directive.
fEHR: electronic health record.
gMDPOA: Medical Durable Power of Attorney.
hQOL: quality of life.
iPRO: patient-reported outcome.
jEMR: electronic medical record.
kPROMIS: Patient-Reported Outcomes Measurement Information System.
le-PRO: electronic patient-reported outcome.
mPSA: prostate-specific antigen
nCaS-PET: Cancer Survivorship Patient Engagement Toolkit.
All five tools addressing ethical and legal aspects of care center on ACP, including ACP education and the opportunity to complete documentation of advance directive, or of an appointed MDPOA or health care proxy. The ACP tools in each of these patient portals provide education and a means to facilitate documentation of advance care preferences. We identified two tools (PatientSite and MyChart) that use a guided, patient-centered questionnaire to enable the completion of an advance directive [
The identified PCEOL patient portal tools addressing physical aspects of care focus on improving the quality of life of patients with serious illness. Four of the five tools identified allow users to complete patient-reported outcome assessments and other questionnaires electronically [
Similarly, MyAVL (MijnAVL), a patient portal for patients with breast and non–small cell lung cancer in the Netherlands, allows users to complete quality of life and physical activity questionnaires. Users are provided with tailored physical activity advice based on their responses. The commercially developed Carevive Care Planning System allows for the collection of patient-reported outcomes in patients with breast and gynecological cancers [
Only one of the tools addressing quality of life, the Patient-Centered Tool Kit (PCTK), was designed for use during acute hospitalization [
Two of the PCEOL patient portal tools addressed the psychological aspects of care, primarily providing resources for psychosocial support. The British Columbia Cancer Agency developed the
Portal use measures were described for nearly all (n=10) patient portal tools in at least one study.
Overall, an overview of appointments and medical records were the most frequently accessed features for portals [
Studies for four of the portals specifically described methods of promoting portal use, either by reminders via electronic messages [
Usability, acceptability, and user satisfaction were formally evaluated for nine of the identified PCEOL patient portal tools (
Users viewed these tools as a means of improving communication. In particular, the integration of tools with electronic medical records was valued. In ACP tools, users appreciated that the advance directive forms were easily retrievable and viewable for their providers and family [
Portal tool usability and satisfaction.
Portal tool | Usability sample size (overall sample size) | Data collection | Mean usability or satisfaction scores or qualitative comments | Comments for improvement |
PatientSite [ |
74 (200) |
Qualitative feedback |
Patient participants had positive feedback on usability, tool prompted patients to take the time to think about their HCPa, gave them an opportunity to improve their HCP information, and helped patients tackle this difficult topic |
Patients made minor suggestions to improve the capability to edit form directly, to improve the ease of printing the form, and to add ability to appoint an additional HCP. |
MyHealth Connection (Epic) [ |
11 (2814) 46 (46); 63% female; mean age 49 years |
SUSb Qualitative feedback |
89 (a total of 70 or greater is typically considered acceptable for usability) Patients were generally satisfied with the ease of use and were likely to recommend using the tool for ACPc documentation to others. |
N/Ad |
My Health Manager (Epic) [ |
24 (24); 71% female; 79% White; mean age 78 years (SD 5.4) |
Qualitative feedback (focus groups) |
Most participants reported interest in having ADe documentation features available in the electronic medical record |
N/A |
PCTKf [ |
18 (239); 10 patients; 50% female; 80% White; 70% >51 years 8 caregivers; 75% female; 87% White; 87% >51 years |
SUS |
74 (a total of 70 or greater is typically considered acceptable for usability) |
Feedback included suggestion for improving technical features and displays to enhance clinical communication. |
MyAVL (MijnAVL) [ |
28 (37) 92 (92); all female; mean age 49 years (SD 11.4) |
WUSg; UTAUTh WUS; UTAUT |
3.9 (maximum score of 5, indicated the highest level of satisfaction); 93% reported tool easy to use, 69% reported tool valuable addition to health care experience 3.8; 75% reported tool easy to use |
N/A Focus groups expressed overall satisfaction with portal features, however expressed desire for educational content to be more tailored to their specific condition |
Carevive Care Planning System [ |
94 (121) |
SUS |
83 (a total of 70 or greater is typically considered acceptable for usability) |
N/A |
Renal PatientView [ |
190 (190) [ 10 (10); 20% female; mean age 59 years |
Investigator-developed questionnaire Qualitative feedback |
45% of inactive users cited computer or password issues as primary issue for nonuse; 37% of inactive users said portal did not anything to their relationship with clinicians Patients found the portal valuable to help prepare themselves and family for changes in care and had better understanding of how their symptoms, blood results, and physiological changes were connected; able to better involve family in care |
N/A N/A |
Provider [ |
22 (22); all male; 95% White; mean age 64 years; range 51-76 years |
Questionnaire not specified |
88% of respondents rated overall satisfaction as excellent or very good; 88% of respondents would continue to use the tool |
N/A |
CaS-PETi [ |
30 (30); 77% female; 33% White; mean age 56 years (SD 13.6) |
Health Website Usability Questionnaire subscale; open-ended questions |
Most patients (n=22) found the portal helpful and reported having helpful information or that it helped them stay healthy |
N/A |
aHCP: health care proxy.
bSUS: Systematic Usability Scale.
cACP: advance care planning.
dN/A: not applicable.
eAD: advance directive.
fPCTK: Patient-Centered Tool Kit.
gWUSQ: Website User Satisfaction.
hUTAUT: Unified Theory of Acceptance and Use of Technology.
iCaS-PET: Cancer Survivorship Patient Engagement Toolkit.
Patient portals may offer accessible avenues for keeping individuals with serious illness and their caregivers connected to PCEOL resources. Although the use of patient portals among patients with serious life-limiting illness is of growing interest, previous studies suggest that patients with serious illness and their caregivers are potentially extensive users of patient portal tools that are commonly available, particularly to access care team information, review laboratory results, and obtain medical records [
The results identified 12 unique patient portal resources supporting the following PCEOL domains: ethical or legal (in the case of this review, exclusively ACP education; n=5), physical (including symptom monitoring, goals of care, and patient-reported outcomes; n=5), and psychological support (n=2). Most resources were targeted toward patient audiences (n=9), with the remainder being targeted toward caregivers, or both patients and caregivers. Only two resources focused specifically on the user characteristics of older adults [
Evidence demonstrates that patients living with serious illnesses and their family members and caregivers can benefit from palliative care [
Furthermore, the role of digital health solutions, including patient portal resources, is more important than ever in the wake of the COVID-19 pandemic. Health systems across the United States, and the globe, are forced to incorporate digital care as part of their regular repertoire of available patient care as safety precautions and social distancing have become the norm [
Nearly all the portals included in this review focused on quality of life, symptom management, or ACP education or completion of advance directives. ACP may be better leveraged through patient portals than other resource types given its more limited and specific goal than some of the more complex and nuanced needs and components inherent in PCEOL care. Similarly, PROMIS tools and other electronic mechanisms for patient-reported outcomes are well suited for patient portals.
Although the legal and physical aspects are essential pieces of quality and holistic PCEOL services, equally important are the psychological and spiritual aspects, as well as end-of-life education around hospice. Only two of the portals reviewed focused on the psychological needs of patients with serious illness [
It is important to emphasize the special consideration of older adult patients with serious illness and patient portal tool development, availability, and adoption among PCEOL populations. In total, 80% of older adults in the United States have one or more chronic conditions, many of which can lead to serious illness [
To the best of our knowledge, this scoping review is the first to identify and describe patient portals that offer PCEOL features. However, this is not without limitations. First, the review only included results from academic literature and may be missing commercially available portals that were developed by industry without concurrent publication in the peer-reviewed literature. In addition, we did not evaluate the full text of articles in which we were unable to retrieve access, potentially overlooking additional PCEOL patient portal resources. Although some of the articles described the efficacy on clinically meaningful outcomes, we did not address this information as it was beyond the scope of our scoping view. Future research should focus on the efficacy of such tools. Finally, this review had a small sample size of articles (n=19) covering 12 different patient portals that are predominantly US based, potentially limiting the results to a Westernized PCEOL perspective.
The scoping review highlighted an important gap in PCEOL resources offered via patient portals linked to electronic health records, as well as opportunities for leveraging patient portals as a means of offering education and support for patients with serious illness. The results suggest that there are ongoing efforts to offer various PCEOL supports through patient portals, particularly with a focus on ACP. However, our review resulted in a small number of portals that met our criteria, of which included only a few of the expansive elements of PCEOL care. Future research and development of patient portals would benefit from offering comprehensive PCEOL features to increase access and education for patients experiencing serious illness.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) checklist.
Scoping review search terms.
advance care planning
Medical Durable Power of Attorney
palliative care and end-of-life
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Patient-Reported Outcomes Measurement Information System
This research was funded by the Medical Student Training in Aging Research Program, the National Institute on Aging (T35AG026736), the John A. Hartford Foundation, and the Lillian R. Gleitsman Foundation. JP was supported by the National Institute on Aging (NIA K76AG059934).
None declared.