Skip to main content Accessibility help


  • Hannah D. Caldwell (a1), Neil B. Minkoff (a2) and Kalyani Murthy (a3)


Objectives: Patient Web portals (PWPs) have been gaining traction as a means to collect patient-reported outcomes and maintain quality patient care between office visits. PWPs have the potential to impact patient–provider relationships by rendering additional channels for communication outside of clinic visits and could help in the management of common chronic medical conditions. Studies documenting their effect in primary care settings are limited. This perspective aims to summarize the benefits and drawbacks of using PWPs in the management of chronic conditions, such as diabetes mellitus, hypertension, and asthma, focusing on communication, disease management, compliance, potential barriers, and the impact on patient–provider dynamic. After a review of these topics, we present potential future directions.

Methods: We conducted an exploratory PubMed search of the literature published from inception through December 2015, and focused our subsequent searches specifically to assess benefits and drawbacks of using PWPs in the management of diabetes mellitus, hypertension, and asthma.

Results: Our search revealed several potential benefits of PWP implementation in the management of chronic conditions with regards to patient–provider relationships, such as improved communication, disease management, and compliance. We also noted drawbacks such as potentially unreliable reporting, barriers to use, and increased workload.

Conclusions: PWPs offer opportunities for patients to report symptoms and outcomes in a timely manner and allow for secure online communication with providers. Despite the drawbacks noted, the overall benefits from successful PWP implementation could improve patient–provider relationships and help in the management of chronic conditions, such as diabetes mellitus, hypertension, and asthma.



Hide All
1. U.S. Department of Health and Human Services Food and Drug Administration. Guidance for industry patient-reported outcome measures: Use in medical product development to support labeling claims. (accessed April 11, 2016).
2. Coons, SJ, Gwaltney, CJ, Hays, RD, et al. Recommendations on evidence needed to support measurement equivalence between electronic and paper-based patient-reported outcome (PRO) measures: ISPOR ePRO Good Research Practices Task Force report. Value Health. 2009;12:419429.
3. Basch, E, Deal, AM, Kris, MG, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: A randomized controlled trial. J Clin Oncol. 2016;34:557565.
4. Berry, DL, Blumenstein, BA, Halpenny, B, et al. Enhancing patient-provider communication with the electronic self-report assessment for cancer: A randomized trial. J Clin Oncol. 2011;29:10291035.
5. Fiks, AG, Mayne, SL, Karavite, DJ, et al. Parent-reported outcomes of a shared decision-making portal in asthma: A practice-based RCT. Pediatrics. 2015;135:e965e973.
6. Bernocchi, P, Scalvini, S, Bertacchini, F, Rivadossi, F, Muiesan, ML. Home based telemedicine intervention for patients with uncontrolled hypertension–A real life non-randomized study. BMC Med Inform Decis Mak. 2014;14:52.
7. Green, BB, Cook, AJ, Ralston, JD, et al. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: A randomized controlled trial. JAMA. 2008;299:28572867.
8. McKinstry, B, Hanley, J, Wild, S, et al. Telemonitoring based service redesign for the management of uncontrolled hypertension: Multicentre randomised controlled trial. BMJ. 2013;346:f3030.
9. Lau, M, Campbell, H, Tang, T, Thompson, DJ, Elliott, T. Impact of patient use of an online patient portal on diabetes outcomes. Can J Diabetes. 2014;38:1721.
10. Osborn, CY, Mayberry, LS, Mulvaney, SA, Hess, R. Patient web portals to improve diabetes outcomes: A systematic review. Curr Diab Rep. 2010;10:422435.
11. Centers for Disease Control and Prevention. National Ambulatory Medical Care Survey: 2012 State and National Summary Tables. (accessed December 2, 2016).
12. Thom, DH, Kravitz, RL, Bell, RA, Krupac, E, Azari, R. Patient trust in the physician: Relationship to patient requests. Fam Pract. 2002;19:476483.
13. Das, A, Faxvaag, A, Svanæs, D. The impact of an eHealth portal on health care professionals' interaction with patients: Qualitative study. J Med Internet Res. 2015;17:e267.
14. Tai-Seale, M, McGuire, TG, Zhang, W. Time allocation in primary care office visits. Health Serv Res. 2007;42:18711894.
15. Akram, K, Pedersen-Bjergaard, U, Borch-Johnsen, K, Thorsteinsson, B. Recall of severe hypoglycaemic episodes and course of hypoglycaemia awareness in insulin treated type 2 diabetes in one year follow-up (Abstract). Diabetologia. 2003;46:A304.
16. Centers for Disease Control and Prevention. National Hospital Ambulatory Medical Care Survey: 2011 Emergency Department Summary Tables. (accessed April 11, 2016).
17. Vietri, JT, Wlodarczyk, CS, Lorenzo, R, Rajpathak, S. Missed doses of oral antihyperglycemic medications in US adults with type 2 diabetes mellitus: Prevalence and self-reported reasons. Curr Med Res Opin. 2016;32:15191527.
18. Agarwal, R, Bills, JE, Hecht, TJ, Light, RP. Role of home blood pressure monitoring in overcoming therapeutic inertia and improving hypertension control: A systematic review and meta-analysis. Hypertension. 2011;57:2938.
19. Bheekie, A, Syce, JA, Weinberg, EG. Peak expiratory flow rate and symptom self-monitoring of asthma initiated from community pharmacies. J Clin Pharm Ther. 2001;26:287296.
20. Stirratt, MJ, Dunbar-Jacob, J, Crane, HM, et al. Self-report measures of medication adherence behavior: Recommendations on optimal use. Transl Behav Med. 2015;5:470482.
21. Internet Live Stats. Internet Users by Country (2016). (accessed April 11, 2016).
22. Pew Research Center. U.S. Smartphone Use in 2015. (accessed April 15, 2016).
23. Harle, CA, Listhaus, A, Covarrubias, CM, et al. Overcoming barriers to implementing patient-reported outcomes in an electronic health record: A case report. J Am Med Inform Assoc. 2016;23:7479.
24. Foster, JM, Smith, L, Usherwood, T, Sawyer, SM, Rand, CS, Reddel, HK. The reliability and patient acceptability of the SmartTrack device: A new electronic monitor and reminder device for metered dose inhalers. J Asthma. 2012;49:657662.
25. Årsand, E, Frøisland, DH, Skrøvseth, SO, et al. Mobile health applications to assist patients with diabetes: Lessons learned and design implications. J Diabetes Sci Technol. 2012;1;6:11971206.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed