When traditionally inseparable services are separated by technology: the case of patient portal features offered by primary care providers

Health-care services have traditionally been provided and consumed simultaneously, as exemplified by in-person patient visits to primary care providers (PCPs), where clinical assessment and treatment are provided and consumed face-to-face. Technological intermediation is changing this traditional assumption, however, as patient-centric technologies, such as patient portals, are creating service separation opportunities. While service separation facilitated by patient portals may bring welcome changes to access, efficiency, and clinical outcomes, usage of patient portals by health-care consumers remains low. Suboptimal demand-side usage of patient portals, especially at the primary care level, could have significant negative implications for patient-centered policy initiatives predicated on patient empowerment and engagement. This paper contributes to this important policy context by reporting findings from a study designed to assess patient perceptions associated with hypothetical patient portal features offered by PCPs and potential subsequent impacts to PCP loyalty and switching propensity. We find that patient portal features focused on back-office (clinical) self-service capabilities (such viewing health records or summaries from prior visits) are perceived positively by consumers, but, interestingly, clinical digital communication and collaboration features (such as online video consultations with physicians) do not have significant perception impacts. These findings suggest that patient portals may act as a complement to health-care service delivery, while substitution for clinical in-person interactions may not be viewed positively.