---
artifact: interview-synthesis
version: "1.0"
created: 2026-01-15
status: complete
context: Health tech company researching patient portal usage to redesign the appointment and records experience
---

# Interview Synthesis: Patient Portal Experience for Chronic Care Management

## Research Overview

### Objective

Understand how patients with chronic conditions (diabetes, hypertension, asthma) use . or avoid using . their healthcare provider's patient portal. Our portal shows 73% registration but only 18% monthly active usage. Identify what would make the portal a regular part of patients' care routine rather than a rarely visited website.

### Methodology

- **Format:** Video calls via Zoom (3), phone calls (3), in-person at clinic waiting rooms (2)
- **Duration:** 35 minutes average
- **Interviewer(s):** Dr. Amy Nguyen (Clinical Product), Carlos Vega (UX Research)
- **Date Range:** January 6 to January 15, 2026

### Participant Summary

| ID | Role/Segment | Tenure | Interview Date | Notes |
|----|--------------|--------|----------------|-------|
| P1 | Type 2 diabetes, age 58 | Patient 12 years | Jan 6 | Manages with medication + diet, sees endocrinologist quarterly |
| P2 | Hypertension, age 45 | Patient 5 years | Jan 8 | Tech-savvy, uses multiple health apps |
| P3 | Asthma (moderate persistent), age 34 | Patient 8 years | Jan 9 | Young parent, manages child's asthma too |
| P4 | Type 1 diabetes, age 29 | Patient since childhood | Jan 10 | Uses CGM and insulin pump, very data-driven |
| P5 | Hypertension + pre-diabetes, age 62 | Patient 3 years | Jan 12 | Limited tech comfort, daughter helps with portal |
| P6 | Asthma + anxiety, age 38 | Patient 6 years | Jan 13 | Avoids portal due to health anxiety triggers |
| P7 | Type 2 diabetes, age 51 | Patient 7 years | Jan 14 | Caregiver for parent with same condition |
| P8 | Hypertension, age 41 | Patient 2 years | Jan 15 | Newly diagnosed, still learning to manage |

## Key Themes

### Theme 1: The Portal Is a Destination, Not a Companion

**Prevalence:** 8 of 8 participants

**Summary:** Every participant described the patient portal as something they visit only when forced to . typically to check lab results or schedule an appointment. It requires a deliberate login, navigation through an unfamiliar interface, and memory of what they came for. Nobody described it as part of their health routine. The portal competes with zero-friction daily apps (weather, banking, social media) and loses because it offers no reason to return between appointments.

**Evidence:**
- P1: "I log in maybe twice a year . when my doctor says 'your labs are posted' and when I need to schedule my next visit. Otherwise I forget it exists."
- P3: "I have a glucose app, a fitness tracker, a food diary, and the patient portal. Guess which one I never open? The portal has my most important health data but gives me no reason to look at it."
- P8: "I registered when the nurse told me to. I've logged in once since. The password was expired, I had to reset it, and by then I forgot why I was logging in."

### Theme 2: Lab Results Without Context Create Anxiety, Not Understanding

**Prevalence:** 7 of 8 participants

**Summary:** Lab results . the primary reason patients visit the portal . are presented as raw numbers with reference ranges. Patients see their HbA1c is 7.2 or their blood pressure trending up but don't understand what it means for their specific situation, whether they should be worried, or what to do about it. For patients with health anxiety (P6), raw results without context trigger panic. For less health-literate patients (P5), the numbers are meaningless. The portal creates a moment of high emotional engagement (seeing results) and squanders it by providing no interpretation.

**Evidence:**
- P4: "I got my A1c result . 6.8. Is that good? My target is 7.0 so technically yes, but it went up from 6.5. Should I be worried about the trend? The portal just shows a number and a green checkmark."
- P6: "I stopped checking my results on the portal because every time I see a number flagged as 'abnormal' I spiral. My doctor always says it's fine at my appointment, but for the two weeks between results posting and my visit, I'm anxious."
- P5: "My daughter reads the results and explains them to me. The portal might as well be in a foreign language. LDL, HDL, A1c, eGFR . I don't know what any of this means."

### Theme 3: Medication Management Is a Missed Opportunity

**Prevalence:** 6 of 8 participants

**Summary:** Patients managing chronic conditions take multiple medications daily and struggle with refills, interactions, and adherence tracking. The portal lists medications but does nothing to help manage them. Patients use separate apps, paper charts, or pill organizers . none connected to their medical record. The portal knows their medication list, pharmacy, and refill schedule but doesn't surface any of this as a useful daily feature. Patients described the medication section as "a list I look at when the doctor asks what I'm taking."

**Evidence:**
- P1: "I take five medications. I use a weekly pill organizer and a reminder on my phone. The portal knows all my meds but can't send me a reminder or tell me when to refill. Why?"
- P7: "I manage my own medications and my mother's. It's two portals, two logins, two medication lists that I manually track in a spreadsheet. The one thing I need . a unified view . doesn't exist."
- P3: "My son's asthma medication changed three times this year. Each time I had to manually update my pharmacy app, my reminder app, and the school nurse's list. The portal recorded the change but did nothing with it."

### Theme 4: Messaging the Doctor Is Valued but Feared

**Prevalence:** 5 of 8 participants

**Summary:** Secure messaging with providers is the portal's most appreciated feature, but patients hesitate to use it. They worry about "bothering" their doctor, being charged for the interaction, or not knowing whether their question warrants a message versus a phone call versus an appointment. The messaging interface resembles email, setting expectations that are mismatched with 48-72 hour response times. When doctors do respond, patients find the messages valuable . but the barriers to initiating contact keep usage low.

**Evidence:**
- P2: "I love that I can message my doctor instead of calling. But I always second-guess myself. Is this worth a message? Will I get charged? Will they think I'm being a hypochondriac?"
- P8: "I sent my first message three weeks ago about a blood pressure spike. I didn't hear back for four days. By then I'd already gone to urgent care. If I'd known the response time, I would have just called."
- P4: "I wish there was a triage step. Like, describe your situation and the system tells you: this is a message, this is a phone call, this is an ER visit. Right now I have to make that judgment myself and I'm not a doctor."

## Notable Quotes

> "The portal has my most important health data but gives me no reason to look at it."
> . P3, age 34, asthma patient and parent

> "I stopped checking my results on the portal because every time I see a number flagged as 'abnormal' I spiral."
> . P6, age 38, on health anxiety and raw lab results

> "My daughter reads the results and explains them to me. The portal might as well be in a foreign language."
> . P5, age 62, on health literacy and lab results

> "I take five medications. The portal knows all my meds but can't send me a reminder or tell me when to refill. Why?"
> . P1, age 58, on medication management

> "I wish there was a triage step. Describe your situation and the system tells you: this is a message, this is a phone call, this is an ER visit."
> . P4, age 29, on secure messaging uncertainty

> "I manage my own medications and my mother's. The one thing I need . a unified view . doesn't exist."
> . P7, age 51, on caregiver experience

> "I registered when the nurse told me to. I've logged in once since."
> . P8, age 41, newly diagnosed hypertension patient

## Insights

### Insight 1: Patient portals must earn daily relevance, not assume it

The portal was designed as a medical records repository that patients access on-demand. But patients with chronic conditions need a daily health companion . something that connects to their routine. The portal's value proposition ("access your medical information anytime") assumes patients want to dig through records. In reality, patients want the portal to come to them with relevant, timely, contextual information: "Your A1c improved 0.3 points . keep doing what you're doing" or "Time to refill your metformin . tap to send to CVS." The portal needs to shift from passive archive to proactive health assistant.

**Implication:** Redesign the portal around a personalized daily health dashboard with proactive notifications. Surface daily medication reminders, upcoming refill dates, lab result interpretations, and care plan progress. Push information to patients rather than waiting for them to pull it.

### Insight 2: Lab results are emotional moments that need human interpretation at machine speed

The moment lab results are posted is the highest-engagement, highest-anxiety moment in the patient portal experience. Patients check results within hours of posting and experience immediate emotional reactions . relief, worry, confusion. Providing raw numbers at this moment without context is both a missed opportunity and a potential harm. The portal needs to deliver what the doctor would say if they were sitting next to the patient: "Your A1c went from 7.4 to 7.2 . that's meaningful improvement. Your current plan is working. Keep it up before your next visit." This doesn't replace physician review but provides immediate reassurance and understanding.

**Implication:** Implement AI-assisted result interpretation that provides plain-language context for every lab result, personalized to the patient's condition, history, and care plan. Include trend visualization (improving/stable/worsening), comparison to personal targets, and a clear action ("No action needed" vs. "Your doctor will follow up" vs. "Consider scheduling an appointment").

### Insight 3: Caregivers are invisible power users with unmet needs

Two participants (P5, P7) rely on or serve as caregivers . a pattern that's likely far more prevalent than our sample shows. Caregivers manage multiple patients' health information, coordinate medications across households, and serve as translators between medical systems and patients with limited health literacy or tech comfort. The portal treats every user as an individual patient, providing no caregiver view, no delegation capability, and no multi-patient management. Given that chronic conditions are disproportionately managed with caregiver support, this is a significant blind spot.

**Implication:** Build a caregiver experience with proxy access, multi-patient dashboards, and shared medication management. Allow patients to designate caregivers who can view results, manage medications, and communicate with providers on their behalf . with appropriate consent and audit controls.

## Recommendations

| Priority | Recommendation | Related Insight | Confidence |
|----------|---------------|-----------------|------------|
| 1 | Build personalized daily health dashboard with proactive notifications | Insight 1 | High |
| 2 | Implement AI-assisted plain-language lab result interpretation | Insight 2 | High |
| 3 | Add medication management with reminders, refill tracking, and pharmacy integration | Theme 3 | High |
| 4 | Create caregiver proxy access with multi-patient dashboard | Insight 3 | Medium |
| 5 | Add symptom-based message triage ("Should I message, call, or go in?") | Theme 4 | Medium |

### Recommendation Details

**1. Build Personalized Daily Health Dashboard**

Replace the current login-and-search model with a personalized feed that shows patients what matters today: medications due, upcoming appointments, recent results with plain-language summaries, and care plan progress. Push daily digest notifications (opt-in) with one relevant health action. The goal is to make opening the portal a 30-second daily habit, not a 10-minute quarterly chore.

**Next steps:** Design prototype of daily dashboard with P1, P3, and P4 as design partners; pilot with 500 chronic care patients measuring login frequency and session duration; coordinate with clinical team on notification content approval workflow.

**2. Implement AI-Assisted Lab Result Interpretation**

When lab results are posted, automatically generate a plain-language summary personalized to the patient's condition and history. Show trend direction (up/down/stable), comparison to their personal targets, and a clear action statement. Flag results that need physician review with expected response timeline. For patients with health anxiety profiles, offer an option to receive results with their doctor's interpretation only (delayed but contextualized).

**Next steps:** Clinical validation of AI interpretation accuracy with 1,000 historical lab results; IRB review for patient-facing AI health communication; design review with P6 specifically for anxiety-sensitive presentation; phased rollout starting with diabetes patients (most structured interpretation guidelines).

## Appendix

### Methodology Notes

Participants were recruited from three clinic locations within our health system network. We selected patients with at least one chronic condition diagnosis and a registered portal account. The sample was intentionally diverse in age, tech comfort, and portal engagement level (including non-users with registered accounts). In-clinic interviews were conducted in waiting rooms before appointments, providing naturalistic context. Phone interviews accommodated participants with limited tech access or preference for voice communication.

### Limitations

- All participants are within a single health system . portal experience, clinical workflows, and provider communication norms may vary across systems
- Skewed toward English-speaking participants . non-English-speaking patients face additional portal barriers not captured here
- No participants under 25 . younger chronic condition patients (e.g., Type 1 diabetes in teens/young adults) may have different expectations
- Caregiver insight based on only 2 participants (P5, P7) . warrants dedicated caregiver-focused research
- Clinical accuracy of AI-assisted interpretation recommendations requires validation beyond this qualitative study
- Did not include provider perspective on messaging workload and expectations . recommend paired provider study

### Raw Notes

Detailed interview transcripts stored in REDCap research database: [Study ID: PX-2026-014 / Patient Portal Chronic Care]
Interview recordings stored per IRB protocol #2026-0142 with 3-year retention policy.
