Date of Conferral
Doctor of Nursing Practice (DNP)
Patrick A. Palmieri
Patient engagement is one of the 6 quality directives issued by the Institute of Medicine for patient-centered care. Federal meaningful use regulations require health care organizations to offer patients a secure online website, or patient portal, to access their health information. Although the patient portal offers patients the opportunity to be more involved in their care, the portal has not been widely used. However, barriers to utilization are best understood from the perspective of the patient. Any barriers to patients accessing the portal are also barriers to patient engagement. The purpose of this project was to understand from the patient perspective why 99% were not using the portal at a large health system. The goal was to understand the patient preferences and their expectations for the portal as well as the perceived barriers. The Diffusion of Innovation Theory guided this quality improvement project to understand the patient perspective to initiate focused portal revisions and program changes. A focus group method was used to interview patients about their portal knowledge, willingness to use the portal, and general preferences for accessing health information. Four focus groups were conducted with 15 participants. Each session was recorded, transcribed within the program NVivo, and reviewed through content analysis. The main barrier to patient portal use is a general knowledge deficit about the purpose, usefulness, and accessibility. As possible solutions, the participants suggested education and promotion materials are essential. Also, nursing staff will need to offer patients information about how to access and use the portal. Through this project, positive social change can be achieved as patients will have better access to their personal health information with the revised portal.