There is little to no evidence that secure messaging portals in electronic health record systems improve outcomes or reduce costs, according to a systematic review of 46 studies published over more than two decades, Modern Healthcare‘s “Vital Signs” reports.

Details of Review

The review — which was published in the Annals of Internal Medicine— was funded by the Department of Veterans Affairs and conducted by researchers from VA and academic medical centers in Los Angeles and Indianapolis.

The review included:

  • 21 observational studies;
  • 14 randomized control trials (Robeznieks, “Vital Signs,” Modern Healthcare, 11/21);
  • 6 qualitative studies; and
  • 5 quantitative, descriptive studies (Lubick Goldzweig et al,Annals of Internal Medicine, 11/19).

The review found that portal use was linked with improved outcomes for patients with chronic diseases, but the improvements also were associated with portals used in case management. As a result, the researchers were unable to identify whether the portals were responsible for the improved outcomes.


The researchers wrote, “Preliminary evidence suggests that, like many health IT tools, enhanced outcomes are realized when [portals] are implemented as elements of more comprehensive programs that link the tool with other approaches.”

They concluded that it is “unlikely that patient portals will have substantial effects on utilization or efficiency, at least in the near term.” They also noted that “more studies are needed to evaluate their cost implications” (“Vital Signs,” Modern Healthcare, 11/21).


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