Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing



Date of Original Version



As part the U.S. government’s ongoing efforts to improve health care quality, the Electronic Health Records (EHR) Incentive Program from the Centers for Medicare and Medicaid (CMS) offers financial incentives to eligible health care providers (EP) who adopt, implement, improve, and demonstrate meaningful use of EHR. Beginning 2014, the Stage 2 Meaningful Use core objectives included the ability of patients to use online patient portals to view, download and transmit their health information. As a result, many EP offer a patient portal and encourage sign up, yet not all patients have done so. How patients perceive the patient portal, whether positively or negatively, may affect their adoption and use of the portal. A survey collected attitudes and beliefs about the patient portal from adult, female, primary care patients (n=257). The beliefs of patients who signed up, along with those who had not, were considered within the framework of the theory of planned behavior (TPB) to identify methods to increase patient use of the portal. The TPB correctly predicted portal sign up behavior in attitude (p<0.05) and intention (p<0.05) subscales. Overall, patients viewed portal characteristics as useful, but patients who had signed up identified them as significantly (p<0.01) more useful, and also, were found to have significantly (p<0.05) more education than those who did not sign up. Few methods to increase patient sign up were identified apart from targeted education to promote the portal’s usability and utility. More research is needed to identify potential methods health care providers can use to increase portal use in primary care patient populations. Implications for advanced public health nurse practice, training, policy, and research were identified and recommendations given.