Why therapists are moving away from Hushmail and portal-based solutions

According to the study Toward Normalizing Inclusive Design by Uncovering Patient Experiences of a Web Portal in a Dental Hospital: Mixed Methods Study, portal-based solutions were created "to support patient appointment bookings, reminders, and communication with healthcare providers via secure messaging from anywhere on the internet." These portals have been reported to increase health status awareness and improve adherence to therapy and medications. However, they have also unintentionally introduced barriers that limit accessibility and personalization for patients. As a result of these challenges, therapists, and other healthcare providers, may choose to move away from using platforms like Hushmail and similar portal-based communication tools.

Disadvantages of using portal-based solutions in healthcare

While patient portals and simiit ratherlar digital solutions have promising benefits, research has identified several disadvantages and limitations that challenge their practical effectiveness. The study Barriers to Patient Portal Access and Use: Evidence from the Health Information National Trends Survey identifies numerous key limitations of portal-based healthcare solutions:

• Limited access and low uptake among many patients: The study shows that less than half of patients were offered portal access, and only about a third reported ever using one. Access was strongly associated with having a regular doctor, higher education levels, English proficiency, and health insurance. This suggests that portals often unintentionally exclude vulnerable groups rather than expanding access.
• Usability and digital-literacy barriers: Many patients experience difficulties navigating portals, interpreting medical information, and troubleshooting technical issues. Patients with limited health literacy or English proficiency face additional obstacles, making portals functionally inaccessible for large segments of the population.
• Privacy, security, and trust concerns: Some individuals are hesitant to access sensitive health information through digital portals due to concerns about data security. This mistrust is especially common among those with less stable healthcare access or poorer health status.
• Inconsistent benefits and unclear impact on health outcomes: Even when patients gain access, many do not use the portal beyond an initial login. Access alone does not ensure meaningful engagement. Without proper guidance, patients can feel confused or anxious when viewing medical results or clinical notes, reducing the intended benefits. Evidence also shows limited consistent improvement in measurable health outcomes.
• Risk of worsening health disparities: Because portal usage is tied to socioeconomic factors, such as education, income, and internet access, these systems often amplify the digital divide. As a result, portals may deepen existing inequities in healthcare access and information availability.

Go deeper: The disadvantages of patient portals

Healthcare alternatives to Hushmail and other portal-based solutions

Patient portals are not always the most accessible or effective way for patients and providers to communicate. The study Barriers to Patient Portal Access and Use: Evidence from the Health Information National Trends Survey proves that many patients struggle with portal logins, navigation, or limited mobile usability, and clinicians often need more flexible tools for timely communication. Consequently, healthcare organizations, such as therapy practices, are increasingly seeking alternative solutions that provide easier access, enhance engagement, and better align with real-world workflows.

Telehealth and virtual care platforms

Telehealth platforms, like Zoom include secure chat, video calls, and document sharing built into the visit workflow. These platforms can be used as an alternative to portal-based communication platforms because patients can receive links that authenticate them directly into their virtual session or secure chat.

According to an article published by Harvard Health, the advantages of telemedicine include: 

• Cost savings and convenience: Telehealth reduces travel time, transportation costs, and time away from work or other responsibilities, making care more accessible and convenient for patients. 
• Improved access for people with mobility limitations or in remote/rural areas: People who live far from clinics, have limited mobility, or lack local access to healthcare providers can receive care remotely. Telehealth can help bridge this gap by providing remote healthcare.
• Flexibility and ease of use: Telehealth enables virtual visits via computer or smartphone, which can be more flexible and easier to fit into people’s schedules compared with in-person visits. 
• Remote monitoring and data sharing: Patients can send health data, like blood pressure, blood sugar, weight, or other readings, manually or via wearable devices, to providers, enabling ongoing monitoring without clinic visits. 
• Coordinated care and improved communication among providers: Telehealth can facilitate sharing of test results, diagnoses, medications, and medical history among all providers a patient sees, improving continuity of care.

Secure messaging apps

Secure messaging apps are specialized applications or services designed to encrypt messages, maintain audit logs, and manage access. In healthcare, they support the “delivery of messages containing clinical documents and/or other information between healthcare organizations, sent either directly or through one or more secure messaging providers,” says the Australian Digital Health Agency.

The article notes that healthcare providers benefit by:

• “Improved timeliness for the sending and receipt of referrals and clinical information
• Improved clinical decisions due to the right information being available at the point of care
• Access to a broader range of referring practitioners
• Streamlined administration due to reduction in paper-based processes
• Improved coordination of care as a result of improved communication between healthcare providers
• Confidence in privacy and security of transmitted patient data
• Improved traceability and tracking of information for audit purposes.”

Secure email

Stephen Ginn from Cambridge University notes that “email is a major means of communication in healthcare and it facilitates the fast delivery of messages and information.” With more than 251 million emails exchanged among global users every minute, secure email platforms may be the best option for patient/client communication.

According to Ginn, the benefits of email for both provider and client/patient include the following:

• Emails can be sent almost instantly and at little to no cost for both the sender and recipient.
• Email can remove the need for more time-consuming interactions, such as phone calls or face-to-face meetings.
• Digital images and documents can be transferred with ease.
• Messages can be sent and read at a convenient time, even outside of typical office hours.
• Emails act as reference tools for recipients, helping to recall and offer proof of the exchange.
• Email facilitates communication with large groups.

See also: HIPAA Compliant Email: The Definitive Guide (2025 Update)

Why choose Paubox over Hushmail

Paubox is often preferred over Hushmail in healthcare settings because it offers automatic, default encryption for all outgoing emails, reducing the risk of human error and ensuring HIPAA compliance without extra steps. Unlike Hushmail’s portal-based system, Paubox delivers encrypted emails directly to recipients’ regular inboxes whenever possible, creating a seamless experience for both senders and recipients. Additionally, Paubox integrates smoothly with existing email platforms like Google Workspace and Microsoft 365, making it easier for organizations to maintain their workflows while enhancing security and compliance.

Go deeper: Paubox vs. Hushmail: HIPAA compliant email software review

FAQS

Is it possible to integrate alternative communication methods with electronic health records (EHR)?

HIPAA compliant communication platforms, like Paubox, offer EHR integration, allowing messages and shared documents to be linked directly to patient records for seamless documentation and workflow.

Will switching from portals reduce patient engagement?

Many patients are more responsive to email, text, or app-based communication than they are to portals. Offering multiple communication options typically increases engagement, especially for patients who prefer simpler tools.

Do portal alternatives offer two-way communication?

Most alternatives, such as secure email, telehealth messaging, and encrypted apps, support two-way communication. Traditional SMS-only systems may be limited unless integrated with a secure messaging platform.