Factors affecting engagement with a patient portal in a tertiary children's hospital: A qualitative study

Background: Patient portals have been shown to be beneficial for caregivers of children with chronic diseases, simplifying appointment-booking processes and improving communication between healthcare teams and families. However, there is low uptake of patient portals in this community. Despite some research into barriers of portal use among adults with chronic conditions, there is limited understanding of barriers to portal use among parents of children with chronic conditions. This study aimed to explore the perceived barriers to engaging with a patient portal among caregivers of children attending a tertiary children's hospital. Materials and methods: A qualitative study was conducted with a purposive sample of participants (n = 7) who were caregivers of patients at a tertiary children's hospital, and not using the patient portal. Semi-structured interviews were audio recorded, transcribed and deidentified before being thematically analysed using the Technology Acceptance Model (TAM). Results: Six themes emerged; four fit into the two TAM categories: perceived ease of use (technical difficulties and patient portal design) and perceived usefulness (existing system and process, and appropriateness for patient context). Two additional factors were found: awareness of the patient portal and attitudes towards technology. Conclusions: Participants identified barriers to patient portal uptake that broadly aligned with the TAM and with barriers affecting self-managing adults. The need for the portal to be easily integrated into caregivers’ busy schedules appeared to be more evident in this study than in those exploring factors affecting self-managing adults