Numerous healthcare institutions across the U.S. offer digital tools to support acute and post-acute patient care. Patient portals, which are secure online platforms accessed through digital devices, can be used for various purposes such as secure health messaging and accessing health information. Stroke survivors may face cognitive and physical impairments that restrict their ability to engage with such technology. This study aimed to identify the barriers and facilitators associated with the use of digital interventions, such as patient portals, to better understand how patients with stroke and transient ischemic attack (TIA) utilize digital technology in post-acute care. We conducted semi-structured, in-depth interviews with patients diagnosed with stroke or TIA and their caregivers from a comprehensive stroke center located in the Texas Medical Center in Houston, Texas. Interview transcripts were coded using a priori codes and thematic analysis was conducted with a deductive approach. Participants were eligible to participate if they were 18 and older with a history of stroke or TIA. Of 18 participants interviewed, over 75% of participants had some experience utilizing a patient portal. Cited barriers to utilization of the patient portals included difficulty logging into the patient portal, poor design of the patient portal and low levels of digital literacy. Participants identified facilitators of patient portal use such as an alternative log-in method through facial recognition and support from family members. Participants suggested that assistance with patient portal setup and a run-through of the portal before leaving the clinic or hospital would be helpful. Patient portals can facilitate patient-provider communication and provide additional support to patients and caregivers after discharge. Healthcare administrators may consider how to efficiently allocate resources, including support staff, to support patient portal usage. To increase patient portal uptake and utilization, organizations must account for the preferences and needs of stroke survivors and caregivers.
Kaur et al. (Wed,) studied this question.