Those that did include any portal instructions included more operational and legal information, such as how to sign on and liability limits, rather than examples of what medical circumstances constitute the best times to use portals. Many with secure messaging offered generic statements to describe the function, with phrases such as “send and receive messages from staff” and no explanation of what content would be appropriate to message. Some guidance also comprised complicated language and vocabulary that may be hard for a general audience to understand.

“The important thing for providers to do (and patients can do the same when they ask their providers) is to make sure that they are on the same page with their patients about who should be using the portal, during what circumstances, and for what,” said Lee. “This is perhaps more important for some functions of the portal and not others. There probably isn't much for providers to teach their patients when it comes to a scheduling feature, but for secure messaging, it's important for patients and providers to be on the same page on things like expected response time. And perhaps even the types of questions to ask.”

She adds that in addition to knowing a hospital’s rules around patient portals, providers should “also consider their own preferences and practices, and that of their patients, when they consider what and how to inform patients” about appropriate use of portals and secure messaging.

The authors note that while many instructions require improvement, several providers do possess complete and informative guidance.

The paper is titled Too Many Don'ts and Not Enough Do's? A Survey of Hospitals About Their Portal Instructions for Patients and was published in the Journal of General Internal Medicine.

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