Understanding the role of patient portals in fostering interprofessional collaboration within mental health care settings: A mixed methods study (Preprint)

Abstract

Patient portals are online systems where patients can access their personal health information and communicate with their clinicians. The integration of patient portals into mental health care settings has been evolving over the past decade, as cumulated research to date has highlighted potential role of portals to facilitate positive health outcomes. However, it is currently unknown whether portal use can foster interprofessional collaboration between clinicians and patients, or whether the portal is a tool to support an already established collaborative relationship.

The purpose of this mixed-methods study was to understand how the use of a patient portal within mental health settings can impact the level of interprofessional collaboration between clinicians, and patients.

This study took place in a large mental health care organization in Ontario, Canada. A convergent mixed-methods design was used, where the primary data collection methods included questionnaires and semi-structured interviews with patients who had experience using a portal for their mental health care. For the quantitative strand, participants completed the Healthcare Communication Questionnaire (HCCQ) and the Self-Empowerment subscale of the Mental Health Recovery Measure (MHRM) at three time points (baseline, 3 months of use, 6 months of use) to measure changes in scores over time. For the qualitative strand, semi-structured interviews were conducted at the three-month time point to assess elements of interprofessional collaboration associated with the portal.

For the quantitative strand, 113 participants completed the questionnaire. For the HCCQ scores, the raw means of total scores at the three time points were: Baseline :43.01; 3-month: 43.19; 6-month: 42.74. In the univariate model with time as the only independent variable, the scores did not differ significantly across the three timepoints (P=0.695). For the MHRM scores, the raw mean total scores at the three time points were: Baseline: 10.77; 3-month: 11.09; 6-month:11.10. In the univariate model with time as the only independent variable, the scores did not differ significantly across the three timepoints (P=0.34). For the qualitative strand, ten participants were interviewed and identified various elements of how interprofessional collaboration can be supplemented through use of a patient portal, including improved team functioning, communication, and conflict resolution.

Although the quantitative data produced non-significant findings in interprofessional collaboration scores over time, patients’ narrative accounts described how the portal can support various interprofessional collaboration concepts, such as communication, leadership, and conflict resolution. This provides useful information for clinicians to support the interprofessional relationship when using a portal within a mental health setting.

RR2-10.1136/bmjopen-2018-025508