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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Nov 5, 2019
Open Peer Review Period: Nov 5, 2019 - Dec 31, 2019
(currently open for review)

Adopting patient portals in hospitals: a qualitative study

  • Pauline Hulter; 
  • Bettine Pluut; 
  • Christine Leenen - Brinkhuis; 
  • Marleen de Mul; 
  • Kees Ahaus; 
  • Anne Marie Weggelaar-Jansen; 



Theoretical models help to explain or predict the adoption of eHealth technology and illustrate the complexity of the adoption process. Various models provide insights into general factors that influence the use of eHealth technology. However, they do not give hospitals much actionable knowledge on how to facilitate the adoption process.


Our study aims to provide insights into patient portal adoption processes among patients and hospital staff (including healthcare professionals, managers and administrative clerks). Studying the experiences and views of stakeholders answers this question: How can hospitals encourage patients and healthcare professionals to adopt a patient portal?


22 semi-structured (group) interviews (N=69) in 12 hospitals and four focus groups with members of (semi)national organizations and patient portal suppliers (N=53).


The effort hospitals put into adopting patient portals can be split into three themes. First, informing patients and healthcare professionals about the portal. The communication strategy has four objectives: 1) knowing about the portal, 2) knowing how it works, 3) encouraging visits to the portal and 4) knowing where to get support. Second, embedding the patient portal in the daily routine of healthcare professionals and management with three forms of support: 1) hospital policy, 2) management by numbers, and 3) a structured implementation strategy that includes all staff of one department. This embedding requires changing work processes and routines. Third, adjusting the portal to meet patients’ needs in the effort to optimize user-friendliness in two ways: 1) using patient feedback, and 2) focusing on optimizing the portal for patients with special needs (e.g. low literacy,, low digital skills). Interestingly,hospitals are reluctant to involve patients in the continuous development of patient portals, because they have experienced that nothing can be done with the feedback received (e.g. technologically impossible or too expensive).


Asking stakeholders what they have learned from their attempts to stimulate patient portal use in hospitals elicited rich insights into the adoption process. This practical knowledge helps to translate the relatively abstract success factors one finds in scientific adoption models to the everyday pragmatics of eHealth projects in hospitals.


Please cite as:

Hulter P, Pluut B, Leenen - Brinkhuis C, de Mul M, Ahaus K, Weggelaar-Jansen AM

Adopting patient portals in hospitals: a qualitative study

JMIR Preprints. 05/11/2019:16921

DOI: 10.2196/preprints.16921


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