e-Healthcare: A critical examination of the patient portal initiative in New Zealand

Date
2018
Authors
Elers, Phoebe
Supervisor
Frances, Nelson
Angelique, Nairn
Item type
Thesis
Degree name
Doctor of Philosophy
Journal Title
Journal ISSN
Volume Title
Publisher
Auckland University of Technology
Abstract

This research examines patients' and doctors' perspectives of patient portals and the associated changes the portals may bring to the nature of healthcare in New Zealand. A patient portal is an electronic platform that allows patients to perform various tasks, such as securely messaging their doctors, viewing their medical records, booking appointments, and requesting repeat medication prescriptions. Using a critical approach, I examined promotional material for patient portals in New Zealand before undertaking a series of semi-structured interviews with patients and doctors, which were analysed using thematic analysis. I found that some of the patients viewed the patient portal as a way of managing tasks and facilitating relationships, while others thought it posed the risk of depersonalising medicine. The patients who frequently used a patient portal described how it can result in crucial social and psychological benefits. On the other hand, the doctors I interviewed generally believed that patient portals could increase patients’ engagement and health literacy but considered them to be expensive and time-consuming. Many felt that digital communication could be a way to connect with patients and to preserve patient-doctor relationships but despite the probable advantages to communication, I found that patient portals were not used effectively in many practices, due, in part, to insufficient promotion. In fact, my overall conclusion is that many of the potential benefits of patient portals were not being realised. In the light of this finding, this research questions whether the limited use of patient portals is contributed by a philosophical conflict about how much autonomy and decision-making patients should have.

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Keywords
Patient portal , e-Health , Clinical information systems , Information and communication technologies
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