Assessing the Communication Immediacy of an Online Health Portal: Analysis and Recommendations to Create a Communicatively Competent Health Information System

Jordan Alpert

Major Professor: Gary L. Kreps, PhD, Department of Communication

Committee Members: Kevin Wright, Carla Fisher, Alex Krist

Research Hall, #161
April 13, 2015, 10:30 AM to 08:30 AM


Once promised to revolutionize health care, online health portals have yet to achieve their potential of transforming the communication process between patients and providers. Generally, online health portals are mainly used to deliver lab results, which often generate more questions and concerns without allowing patients an outlet to get answers. Their operation is mandated by the Patient Protection and Affordable Care Act, which subsequently causes providers to minimally and begrudgingly use the technology. One particular online health portal,, has attempted to reverse this treacherous trend by creating a platform that provides tailored health promotion recommendations based on family history, lifestyle habits and medical accounts.

This dissertation examined to assess its levels of immediacy, including such factors as personalization, interactivity, engagement, approachability, clarity and the ability to take action. The purpose of the study was to determine how patients and providers regard the system so that refinements could be recommended for future improvements. Mixed-methodology was employed with 31 qualitative patient interviews and two focus groups with providers utilizing the Critical Incident Technique. Over 140 incidents were gathered, of which 72% were negative and 28% were positive. Negative incidents among patients included the following categories: (1) content is generic and standardized, (2) it is unclear whether information is coming directly from the provider, (3) website errors and (4) interpreting data is difficult. Negative incidents among providers centered on (1) ineffective one-way communication, (2) the portal increases workload, (3) verbiage disrupts care and (4) website glitches.

In addition, a thematic textual analysis of the portal was conducted. Positive attributes included pleasant imagery, simple and encouraging language as well as historical medical data. Weaknesses comprised of inconsistent personalization, lack of interactivity and confusing language. Moreover, the CDC’s Clear Communication Index tool was utilized to gauge the clarity of the portal. Once intercoder reliability was established, 37 internal and external webpages were evaluated. The total score among all of the pages was 72%, which falls below the 90% threshold to be considered clear communication. Only four pages received scores of 90% or higher.    

Findings from this study connect with several theories and concepts, such as the Diffusion of Innovations Model, the Technology Acceptance Model, the Relational Health Communication Competence Model and the Self-Efficacy construct. Based upon the data collected, it was concluded that must go beyond simply repeating what patients fill out in the online questionnaire and instead create a dynamic environment that delivers an interactive and personalized experience. The data collected should inform significant refinements in the online health portal that can serve as an extension of the provider by offering patients a customized, robust, easily accessible, and trusted information source to promote patient adherence with medical recommendations and informed health decision making.