Patient portals were supposed to be healthcare’s digital front door. But what’s the use of a door if nobody opens it? After years of investments in portal technology, patient adoption remains dismally low. Nearly half of patients use their healthcare portal less than once a month, including 16% who have never logged in at all.
This stark reality raises an urgent question for health system executives: why aren’t patients engaging with these online tools, and how can we fix it?
Why patients aren’t logging in
Several factors are keeping portal usage stuck in the doldrums. The top reasons patients give for not using portals include:
- Lack of awareness or invitation – Many patients simply aren’t aware a portal exists for them, or they were never properly invited and onboarded. 27% of non-users said they were unaware of their portal or didn’t know how to access it. Implementing a portal and sending a one-time sign-up email isn’t enough. If patients aren’t proactively educated and encouraged, most won’t enroll.
- Poor user experience – Even when patients do know about portals, the experience can be cumbersome and inconvenient. Some portals require tedious enrollment steps or have outdated, non–mobile-friendly interfaces. In a world where patients expect convenient or even immersive experiences from businesses they engage with in other areas of life, digital experiences that feel like a hassle are all it takes for an already busy patient to give up.
- Trust and privacy concerns – Trust is another roadblock. Patients are rightly protective of their sensitive health information, and some don’t trust putting it online. About 17% of non-users cite concerns about the security and privacy of patient portals as a major deterrent. High-profile data breaches in healthcare have only amplified these fears. If patients lack confidence that their medical data will remain safe, they won’t engage with a digital tool. In short, a portion of the population avoids portals because it just doesn’t feel secure.
Beyond these factors, usability plays a major role. Portals often require clunky logins, have unfriendly interfaces, or offer limited value (e.g. showing lab results without context or messaging that could have been more easily accomplished through a simple text).
For busy patients, any friction is a deterrent. The result is that many portal features go underutilized. The very tool meant to empower patients can end up feeling like yet another bureaucratic hoop to jump through.
Meeting patients where they are
While portal adoption lags, simpler and smarter outreach methods are proving far more effective at engaging patients. Rather than forcing people to log into a portal, leading providers are reaching out through channels patients already use – like text messages, automated calls, or secure emails – and seeing striking results in boosting patient reach and closing preventive care gaps.
Automating initial outreach and surfacing patients needing attention can dramatically boost engagement without sacrificing the human touch. By using tools that empower staff to focus on meaningful follow-up, patients receive timely, actionable outreach. It’s precisely this kind of multichannel and efficient strategy beyond the portal that helps systems connect with patients where they are.
Rethinking the portal-centric strategy
For healthcare organizations, the takeaway is clear: it’s time to move from a portal-centric engagement strategy to a patient-centric one. If patients aren’t coming to the portal, we need to meet them where they are.
That means embracing a multichannel communication approach and reducing barriers to interaction, all while maintaining the privacy and personal touch that patients value. Here are some key strategies for redesigning patient engagement:
- Meet patients on their terms – Offer multiple communication channels so patients can choose what’s easiest for them. This includes text messaging, phone calls, email, or even chat, not just the portal. By communicating through the medium each patient prefers, you dramatically increase the chances they’ll see and respond to the message.
- Make it convenient and relevant – Remove friction wherever possible. Avoid requiring extra logins or forcing patients to download a separate app for basic tasks. Messages should be timely and tailored. When information is delivered in a useful context (and without hassle), patients are more likely to engage.
- Maintain the human touch – Digital tools should augment human interactions, not replace them. Reassure patients that online communication is an extension of their care team. For instance, an automated follow-up text after a clinic visit should always include a means to easily connect patients with their providers in case it’s needed. This way, patients know there are real people behind the technology.
- Integrate into workflows – Moving beyond the portal means ensuring that whatever communication tools you deploy integrate with your clinicians’ and staff’s workflows. The goal is a seamless experience. Messages to patients should be logged appropriately, and staff should be immediately alerted to important replies or issues. No patient concern slips through the cracks, and providers don’t have to juggle disparate systems or duplicate work.
- Leverage AI to close the loop between information and action – AI-driven engagement can analyze outreach responses, rounding notes, and survey feedback to surface patterns, summarize patient experiences, and proactively flag emerging concerns. Pairing these insights with clear, context-rich messaging allows health systems to ensure patients receive guidance they understand while care teams focus their attention where it’s needed most.
By implementing these strategies, healthcare providers can reduce the barriers that have long stymied portal adoption. It’s not that patient portals have no place, as they remain a useful repository for records and results, but they shouldn’t be the only digital doorway for patient interaction. A modern engagement strategy treats the portal as just one option among many and focuses on designing tools patients actually want to use. Boosting patient engagement isn’t about corralling everyone through a single “front door.” It’s about opening every door that makes it easy for patients to connect with their care. Whether that’s a text, a call, a secure link, or yes, even a portal when appropriate, what matters is meeting patients on their terms. When we do that, we truly unlock the potential of digital health tools.
The truth about patient portals is that engagement comes when we go beyond the portal, creating a healthcare experience that is convenient, trusted, and patient-centered.
Photo credit: ipopba, Getty Images
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