Why therapists are moving away from Zoho Mail and portal-based solutions

Portal-based solutions were designed “to support patient appointment bookings, reminders, and communication with health care providers via secure messaging from anywhere via the internet,” writes the study Toward Normalizing Inclusive Design by Uncovering Patient Experiences of a Web Portal in a Dental Hospital: Mixed Methods Study. “For patients, portals have been reported to benefit clinician-patient relationships, health status awareness, and adherence to therapy and medications.” However, patient portals have unintentionally introduced barriers that reduce accessibility and personalization. This has caused therapists to make a shift from using platforms like Zoho and other portal-based communication tools. 

What is Zoho?

Zoho is a cloud-based Software-as-a-Service (SaaS) platform that provides an extensive suite of business applications designed to streamline communication, collaboration, and day-to-day operations. Its ecosystem includes more than 50 integrated tools, allowing organizations to manage multiple functions from one place.

Key product offerings include:

• Zoho Mail: Business email hosting with custom domains and built-in security features.
• Zoho Cliq: Team messaging platform for real-time communication.
• Zoho Meeting: Video conferencing and webinar solution.
• Zoho WorkDrive: Cloud storage and file-sharing workspace for teams.
• Zoho CRM: Customer relationship management to track leads, clients, and workflows.
• Zoho Books & Zoho Invoice: Accounting, billing, and invoicing tools for small to medium businesses.
• Zoho Projects: Project management for planning, tracking, and collaboration.
• Zoho Desk: Customer support ticketing and helpdesk platform.

How Zoho is used in healthcare

While Zoho is not a dedicated healthcare platform; however, many small practices, clinics, and health-adjacent businesses use it for administrative and operational tasks. Key applications include:

• Zoho Mail (with a signed BAA) for encrypted email communication that supports HIPAA compliance when properly configured.
• Zoho CRM for managing patient inquiries, referral pipelines, appointment requests, and follow-up workflows (without storing PHI unless HIPAA safeguards are in place).
• Zoho Forms for collecting non-sensitive intake data or pre-visit information.
• Zoho Projects / Zoho Desk for care-coordination tasks, case tracking, or managing support requests in larger health organizations.

However, Zoho’s healthcare use is generally limited to administrative workflows. Only Zoho Mail offers the option for a business associate agreement (BAA), meaning most other apps in the Zoho ecosystem cannot be used to handle protected health information (PHI) under HIPAA. As a result, many therapists and healthcare providers use Zoho for business management tasks but rely on purpose-built, HIPAA compliant platforms for clinical communication and documentation.

Disadvantages of using portal-based solutions in healthcare

While patient portals (and similar digital, portal-based solutions) offer potential benefits, research shows several important disadvantages and limitations, many of which challenge their effectiveness in practice. Findings from the study Barriers to Patient Portal Access and Use: Evidence from the Health Information National Trends Survey list several important limitations of portal-based solutions in healthcare:

• 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

Alternatives to patient portals

While patient portals may be widely used, they are not always the most accessible or effective way for patients and providers to communicate. The above study proves that many patients struggle with portal logins, navigation, or limited mobile usability, and clinicians often need more flexible tools for timely communication. As a result, healthcare organizations, including therapists, are increasingly turning to alternative solutions that offer easier access, stronger engagement, and better alignment with real-world workflows.

Telehealth and virtual care platforms

Many telehealth platforms, like Zoom and SimplePractice, now include secure chat, video calls, and document sharing built into the visit workflow. Rather than relying on a portal, 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.

Read also: Why email is the best complement to conventional healthcare

The better solution: Paubox

Paubox is a leading secure email solution tailored for healthcare organizations seeking seamless HIPAA compliant communication. It encrypts emails automatically and delivers them directly to the recipient’s regular inbox without extra steps or passwords. This approach improves patient engagement by making secure communication simple and convenient while maintaining maximum data protection. Paubox also provides robust features such as real-time threat detection, comprehensive audit logs, and a signed business associate agreement (BAA), ensuring full compliance with HIPAA regulations. By easily integrating with existing email systems, Paubox helps healthcare providers streamline workflows, reduce administrative burdens, and safeguard PHI effectively.

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

FAQS

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.

Can alternative communication methods be integrated with electronic health records (EHR)?

Many 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.