A Patient Portal With Electronic Messaging: Controlled Before-and-After Study

Area of Science:

• Health Informatics
• Health Services Research
• Cost-Effectiveness Analysis

Background:

• Patient portals facilitate information exchange and interaction between patients and healthcare providers.
• Improved access to medical records and secure messaging can increase patient engagement in managing their health.
• Patient portals may positively influence the cost-effectiveness of healthcare delivery.

Purpose of the Study:

• To evaluate the benefits and risks of electronic messaging services for patients with chronic conditions.
• To conduct a cost-effectiveness analysis of patient portal access within a primary care setting.
• To assess the impact of patient portals on patient activation and health status.

Main Methods:

• A randomized controlled trial involving 876 chronically ill patients comparing immediate patient portal access to standard care.
• Evaluation of direct healthcare costs, health status (SF-36v2), and patient activation (PAM13) over a 6-month follow-up period.
• Cost-effectiveness ratios calculated using propensity-score matching to address potential attrition bias.

Main Results:

• Patient activation showed a non-significant improvement in the intervention group.
• The impact on healthcare costs was variable, with a slight decrease in the unadjusted model and a slight increase in the adjusted model.
• No significant short-term changes in health status were observed using the SF-36v2 measure.

Conclusions:

• Providing patient portals with self-management tools did not negatively affect chronic care patients' health status or treatment.
• Patient activation increased, suggesting potential for improved long-term health outcomes and reduced resource utilization.
• Further research is needed to determine the long-term effects of patient portals on patient health and healthcare costs.