Workflow impact and outcomes for healthcare communication platforms

The choice between patient portals and email communication systems involves far more than simple preference. It requires consideration of workflow integration, clinician workload, patient outcomes, technology infrastructure, and evolving regulatory requirements. These factors help healthcare organizations make informed decisions about their communication platform investments, ultimately improving both provider efficiency and patient care quality.

Integration and workflow impact

Portal integration and workflow

According to the HIMSS Greater Kansas City Chapter, in an article titled Patient Portal Enrollment and Engagement Rounds on Inpatient Units, "Patient access to online health information has become an essential component of healthcare delivery in the digital age; 90% of healthcare organizations offer patients access to an electronic patient portal." Despite this widespread availability, adoption remains a challenge. The same source states that "in a national cross-sectional survey, more than 50% of survey participants were not portal users."

To improve engagement, healthcare organizations have implemented dedicated portal enrollment and engagement (PEE) rounds. This initiative ensures that hospitalized patients and their families receive direct support in understanding the portal's benefits and enrolling in the system. HIMSS emphasizes that "bringing portal support directly to the bedside eliminated the families' need to inquire about portal registration; moreover, if a family is unaware of the portal and its benefit, they may not ask about the registration process."

According to JMIR Publications, patient portal messaging has led to an increased clinician workload, particularly in primary care settings, where optimization efforts are most needed. The ratio of patient count to clinician count and messages per clinician has steadily risen, indicating a growing burden on healthcare providers. Primary care physicians experience the heaviest per-clinician messaging workload, generating the largest number of messages annually. Meanwhile, nurse practitioners (NPs) and physician assistants (PAs) in primary care, despite being fewer in number, face disproportionately high messaging loads.

The study further outlines that:

• Most clinician messages (93.2%) are sent during standard working hours (7 AM – 5 PM)
• Peak messaging period occurs around noon (17.3%)
• 5.94% of messages are sent after hours (5–11 PM), demonstrating that some clinicians continue their workload beyond regular shifts
• 24% of electronic health record (EHR) work occurs outside clinical hours, further contributing to physician burnout
  
  

Email integration and workflow

Email communication demonstrates more manageable workflow integration compared to complex portal systems. According to The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review, "During a six-week period, two pediatricians estimated spending an average of 30 minutes per day responding to emails". This manageable time commitment stands in contrast to the workload burden created by portal messaging systems.

Furthermore, research shows that "physicians spent more time managing patient phone calls than responding to emails. Satisfied physicians reported that email saved time and helped deliver better care.”

According to ScienceDirect's systematic review, adoption patterns vary based on:

• Physician age: decreased use in those over 61
• Race: decreased use among those of Asian background
• Medical training: higher use in family medicine and surgical specialties
• Practice size: greater use in practices with over 50 physicians

The systematic review further provides that physicians in email-focused intervention groups reported more favorable attitudes toward electronic communication compared to those who did not use email. Additionally, frequent email users had increased satisfaction with the system's convenience and efficiency.

Despite its challenges, “email communication has demonstrated potential in enhancing chronic disease management by improving continuous patient communication and increasing flexibility in handling non-urgent issues.

Quality of care and patient outcomes

The impact of communication methods on patient outcomes represents a consideration for healthcare organizations. As noted in Quality communication can improve patient-centred health outcomes among older patients: a rapid review published in BMC Health Services Research, "Effective communication is a cornerstone of quality healthcare. Communication helps providers bond with patients, forming therapeutic relationships that benefit patient-centred outcomes." This foundational relationship between communication and care quality extends across multiple dimensions of patient experience and health outcomes.

Research indicates that effective patient-provider communication correlates with improved medication adherence, better chronic disease management, and higher patient satisfaction scores. The BMC Health Services Research study reinforces this connection, demonstrating that "effective communication is associated with enhanced patient satisfaction, regulating emotions, and increasing compliance, leading to improved health and better outcomes." Furthermore, the quality of communication directly influences patient perceptions of care, as "quality communication enhances patients' trust in their providers, making patients more satisfied with the treatment. A trusting provider-patient relationship causes individuals to believe they receive better care."

The health benefits of effective communication extend beyond satisfaction measures to encompass wellness outcomes. According to the same research, "effective provider-patient communication improves social, somatic, and psychological health." This holistic impact demonstrates how communication serves as a therapeutic intervention in itself, contributing to patient recovery and well-being across multiple domains.

Patient portals offer health information access, potentially empowering patients to take more active roles in their healthcare management. Patients can review test results, track health metrics over time, and access educational resources, all of which may contribute to better health outcomes. The empowerment aspect is particularly significant, as research shows that "mutual communication between providers and patients stimulates or strengthens patients' perception of control over their health, the knowledge to discern symptoms and self-care and identify changes in their condition." However, the complexity of these systems may overwhelm some patients, potentially creating anxiety or confusion rather than empowerment.

Email communication, while more limited in scope, offers immediate and direct access to healthcare providers for questions and concerns. This accessibility can be particularly valuable for patients managing chronic conditions who need regular check-ins or clarification on treatment protocols. The informal nature of email may also encourage patients to communicate more openly about sensitive health issues.

The measurable impact of effective communication on patient outcomes has been documented across various healthcare settings. Research has shown that communication strategies are "associated with better patient outcomes, such as significant improvements in mental and physical health at four weeks," as reported in the BMC Health Services Research study. This consistency in findings across different research approaches shows the role of communication in healthcare delivery, with studies indicating that "various verbal and nonverbal communication approaches could improve these patient-centred outcomes."

Healthcare organizations must recognize that communication quality serves as both a process measure and an outcome predictor, influencing not only patient satisfaction but also clinical effectiveness, treatment adherence, and overall health improvement. The evidence consistently demonstrates that investing in communication platforms and training represents an investment in patient outcomes and care quality.

Technology infrastructure requirements

The technology infrastructure needed to support patient portals versus email communication systems differs in complexity and resource requirements, particularly as healthcare organizations increasingly embrace cloud-based solutions. The broader healthcare technology landscape reflects this transformation. According to Transforming Healthcare with Secure Cloud Infrastructure,  "the global healthcare cloud computing market experiencing unprecedented growth, valued at USD 34.95 billion in 2022 and projected to reach USD 101.11 billion by 2028, demonstrating a compelling CAGR of 19.4%.”

This market expansion directly impacts communication platform infrastructure decisions. Patient portals typically require:

• Server capacity
• Database management systems
• Backup and disaster recovery protocols
• High performance and security standards for concurrent users

The shift toward cloud infrastructure has changed how healthcare organizations approach these requirements. "Healthcare organizations leveraging cloud solutions have reported a 45% improvement in data security compliance and a 60% enhancement in disaster recovery capabilities,” making cloud-based patient portals increasingly attractive despite their complexity.

Advanced communication platforms are also benefiting from emerging technologies that enhance their capabilities. "Healthcare organizations implementing cloud-based AI solutions have achieved a 39% improvement in diagnostic accuracy and a 45% reduction in time-to-diagnosis for complex cases.” This technological advancement is particularly relevant for patient portals that incorporate clinical decision support and automated patient guidance features.

The rise of telemedicine has further emphasized the importance of communication infrastructure. "The global telemedicine adoption rate has increased by 158% since 2020, with cloud-based solutions supporting an average of 781,000 daily virtual consultations across major healthcare networks.” This increase in virtual care delivery requires communication platforms that can integrate with video conferencing, secure messaging, and real-time health monitoring systems.

Email-based communication systems, particularly cloud-hosted solutions, require minimal on-premises infrastructure while providing scalable solutions that can grow with healthcare organizations. However, they must still meet the same stringent security requirements and increasingly benefit from the same cloud infrastructure advantages that support more complex portal systems.

This difference in infrastructure requirements can impact the total cost of ownership and the complexity of system maintenance over time. Organizations must weigh the enhanced capabilities and integration potential of sophisticated portal systems against the simplicity and lower overhead of email-based solutions, all within the context of rapidly evolving cloud technology capabilities.

Regulatory environment and future considerations

The regulatory landscape surrounding healthcare communication places emphasis on patient privacy, data security, and interoperability requirements. Both patient portals and email systems must adapt to changing regulations and emerging cybersecurity threats.

Recent updates to HIPAA guidelines have clarified requirements for electronic communications, emphasizing the need for:

• Proper patient consent
• Secure transmission methods
• Audit trails

Healthcare organizations must ensure their chosen communication platforms can adapt to future regulatory changes without additional investments.

The push toward interoperability in healthcare systems also affects communication platform selection. Patient portals that integrate with electronic health records and other healthcare systems may provide long-term advantages, while email systems may need additional development to achieve similar integration levels.

Healthcare organizations must also consider the broader context of digital privacy concerns affecting all sectors. As Eva Velasquez, CEO of the Identity Theft Resource Center, noted in Two-Fifths of Americans Want to Ban Biometric Use published in Infosecurity Magazine: "This research highlights a critical need for those of us working to prevent identity crimes to do a better job explaining both the benefits and risks of emerging identity technologies – especially biometrics." She further emphasized that "Change can be uncomfortable, but resisting it without understanding the facts can create unnecessary risk. We must do more to show why secure biometric identity verification is in everyone's best interest." This perspective applies equally to healthcare communication platforms, where patient education about security benefits becomes crucial for adoption success.

Learn more: HIPAA compliant email

FAQs

How do communication preferences differ across patient age groups or digital literacy levels?

Older adults and those with limited digital skills may struggle with patient portals and prefer simpler methods like email or phone.

What are the financial implications of clinician burnout linked to portal messaging?

Burnout caused by increased messaging workloads can lead to higher staff turnover and long-term costs for healthcare organizations.

How does patient portal adoption differ in rural versus urban healthcare settings?

Access to internet infrastructure and digital health literacy often influence lower adoption rates in rural communities.

Can AI or automation reduce the messaging burden on primary care providers?

Emerging AI tools can help triage, auto-respond, or summarize patient queries to ease clinician workload.

How do privacy concerns affect patient willingness to use portals or email communication?

Patients wary of digital privacy risks may opt out of electronic platforms without proper reassurance and education.