Lack of resources, financial difficulties remain top barriers to patient portal implementation

Lacking resources and financial difficulties were reported as the top factors hindering implementation of patient portals, according to a study published in the Journal of Medical Internet Research.

In the study, researchers identified barriers and facilitators leading to the successful implementation of patient portals within hospitals in the Netherlands.

“Previous research focused on patient involvement in developing the portals, but little is yet known about organizational factors that facilitate or hinder patient portal implementation,” wrote first author Laura Kooij, MSc, and colleagues. “Such knowledge is essential because the number of portals is rising. Comprehensive information can provide a framework for upcoming patient portal implementations, or other eHealth applications, in hospitals.”

Researchers analyzed two university medical centers, three teaching hospitals and two general hospitals while also interviewing 21 stakeholders from three locations. In total, 376 quotes, 26 barriers and 28 facilitators were identified.


Facilitators perceived usefulness and a subject’s positive attitude led to successful implementations of patient portals. However, lack of resources, financial difficulties and privacy and security concerns were identified as the main barriers to implementation.

“Patient portal implementation is a complex process and is not only a technical process but also affects the organization and its staff,” concluded Kooji and colleagues. “Barriers and facilitators occurred at various levels and differed among hospital types (lack of accessibility) and stakeholder groups (sufficient resources) in terms of several factors. Our findings underscore the importance of involving multiple stakeholders in portal implementations. We identified a set of barriers and facilitators that are likely to be useful in making strategic and efficient implementation plans.”