Barriers to patient portal access among veterans receiving home-based primary care: a qualitative study

Health Expect. 2015 Dec;18(6):2296-305. doi: 10.1111/hex.12199. Epub 2014 May 12.


Background: Electronic, or web-based, patient portals can improve patient satisfaction, engagement and health outcomes and are becoming more prevalent with the advent of meaningful use incentives. However, adoption rates are low, particularly among vulnerable patient populations, such as those patients who are home-bound with multiple comorbidities. Little is known about how these patients view patient portals or their barriers to using them.

Objective: To identify barriers to and facilitators of using My HealtheVet (MHV), the United States Department of Veterans Affairs (VA) patient portal, among Veterans using home-based primary care services.

Design: Qualitative study using in-depth semi-structured interviews. We conducted a content analysis informed by grounded theory.

Participants: Fourteen Veterans receiving home-based primary care, surrogates of two of these Veterans, and three home-based primary care (HBPC) staff members.

Key results: We identified five themes related to the use of MHV: limited knowledge; satisfaction with current HBPC care; limited computer and Internet access; desire to learn more about MHV and its potential use; and value of surrogates acting as intermediaries between Veterans and MHV.

Conclusions: Despite their limited knowledge of MHV and computer access, home-bound Veterans are interested in accessing MHV and using it as an additional point of care. Surrogates are also potential users of MHV on behalf of these Veterans and may have different barriers to and benefits from use.

Keywords: access to care; health information technology; vulnerable populations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Electronic Health Records / statistics & numerical data*
  • Female
  • Grounded Theory
  • Home Care Services*
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Patient Access to Records*
  • Patient Satisfaction
  • Primary Health Care*
  • Qualitative Research
  • United States
  • United States Department of Veterans Affairs
  • Veterans*