Most of your patients still aren’t using the portal. Here’s why.


Patient portals typically have a lot to offer—instant access to test results and medical records, appointment booking, secure messaging, health-education materials and more. What portals don’t have is a majority of patients using them.

Recently reported survey data shows that 63 percent of adults who were insured and made a health care visit in the previous 12 months had not visited a portal during the preceding year. The findings, published in the journal Health Affairs, indicate a lack of physician, health system and insurer engagement in promoting portal use—nearly 40% of patients in the study reported not being offered it.

The AMA is committed to making technology an asset in the delivery of health care, not a burden. Efforts in this area include creation of the Digital Health Implementation Playbook to speed the adoption and scaling of innovative solutions. (Download the Playbook now.)

Discover more about the AMA’s transformative digital health efforts, including career-long learning at the AMA Ed Hub.™ Read a case study on optimizing a patient portal from the AMA’s STEPS Forward™ collection of practice innovation strategies.

The Health Affairs article, “Who Isn’t Using Patient Portals and Why? Evidence and Implications From a National Sample of U.S. Adults,” cites national health trend data.

Here are the top five reasons why patients skip using the patient portal:

  • Prefer to speak directly with physician—70%.
  • No need to use the portal—57%.
  • No online medical record—32%.
  • No internet access—25%.
  • Privacy concerns—22%.

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The journal article examines portal use with special attention to disparities in care, including the characteristics of patients who frequently are not offered portal use, as well as those less likely to use portals. The study’s authors, from the University of Michigan and the University of Wisconsin-Milwaukee, also examined their reasons why.

The research results sketch a demographic profile of those who didn’t visit a portal compared with patients who did. Nonusers were likelier to be male seniors without a college degree or job. Additionally, nonusers were more likely to live in a rural area, receive Medicaid and lack a regular source of care.

Markedly, nonusers were less likely to have been offered access to a portal. Nearly all portal users—95%—recalled being offered access, though 41% offered access did not use it. Only 5% of patients who said they were not offered access went on to use a portal, though some providers might not have had portal access to offer.

Men, members of racial or ethnic minority groups, Medicaid recipients and patients without a regular source of care were among those less likely to be offered access.

Patients with Medicaid and Medicare coverage, compared to those with commercial plans, were more likely to skip portal use in favor of having a direct conversation with the physician or someone else at the clinic or hospital.

Privacy and security concerns were more likely to be cited among patients older than age 40 and within certain demographic groups—Hispanics, for example—when compared with whites. Among those more likely to report no need to use a portal were Hispanic patients and those older than 50, compared with younger white patients.

The researchers found no demographic differences among nonusers who said that a technology hurdle, lack of internet access or no online medical record was the reason why they did not make use of a patient portal.

“Health care providers and plans can increase patients’ use of portals and narrow disparities in that use through direct communication about the benefits of portals, while also addressing patient-specific needs and concerns,” wrote the study’s authors, Denise L. Anthony, PhD, Celeste Campos-Castillo, PhD, and Paulina S. Lim.

They underscored the importance of physicians and other health professionals to take time—even amid the daunting productivity demands of modern practice—to make all patients aware when a portal is available, encourage its use and to be mindful of the reasons why patients are resistant to using them.