PhD defence P.W. (Pauline) Hulter

Below is a brief summary of the dissertation: 

Navigating Insights Into the Adoption of Patient Portals

Abstract
eHealth technologies, such as patient portals, have not been widely adopted by healthcare professionals (HCPs) and patients. This dissertation aims to gain actionable knowledge on patient portal adoption in daily healthcare practices. The research question is: How can the adoption of patient portals by patients and healthcare professionals be supported in the Netherlands? 
We conducted a qualitative study on the adoption of hospital portals. Stakeholder insights on stimulating portal use provided valuable information previously missing from existing models. We qualitatively studied mental HCPs’ appraisal work of patients' web-based access to electronic health records (EHRs). Findings show HCPs appraise effects of web-based patient access individually, lacking systematization and communal appraisal. Involving HCPs in developing, implementing, and embedding portals is crucial to optimize patient access to EHRs. We presented a mixed-methods study on patients’ choices regarding online access to laboratory, radiology, and pathology results on a hospital portal. Most patients prefer transparency and want their results disclosed as soon as possible. We conducted a discourse analysis to understand what real-time access to test results means for patients. Findings reveal the plurality of patients’ opinions by presenting three discourses on real-time access: a source of stress, anxiety reduction and self-management. 
We categorized the actionable knowledge into four phases: Awareness, Acceptance, Actioning, and Assimilation. These phases may appear chronological, are often interrelated in practice, with elements frequently moving back and forth during the adoption process. Further research can be conducted through action research, where researchers and co-researchers collaborate to develop and apply this knowledge.

Key words: eHealth technologies, patient portals, adoption, adoption process, patient access to test results, real-time access, actionable knowledge.