Caregiver Perspectives on Electronic Portal Use in Integrated Primary Care: Qualitative Study.

BACKGROUND: Pediatric patient care portals through electronic health records (EHRs) provide opportunities to enhance patient care. However, challenges exist for making portals usable, and few studies have examined qualitative experiences of caregivers when using integrated primary care (IPC) services for their children. OBJECTIVE: This study aimed to qualitatively examine barriers to and facilitators of using electronic patient portals in integrated behavioral health care. METHODS: Data were collected from 7 caregivers of pediatric patients (0-7 years old) during focus groups. Interview data were analyzed qualitatively and coded by an interdisciplinary group. An iterative approach identified overarching themes within the following Consolidated Framework for Implementation Research (CFIR) domains: outer setting, inner setting, and characteristics of individuals. RESULTS: Overall, caregivers found the portal beneficial. Six themes emerged during thematic analysis. Outer setting themes were "lags and barriers to care" and "connections with outside providers." Inner setting themes were "putting the 'human' in 'human-centered design'" and "virtual access to information." Characteristics of individuals themes were "flexibility" and "personalization." CONCLUSIONS: The current study sheds light on caregiver perceptions of electronic portal use. Patient portals are an effective and well-received tool for patients with developmental delays and families accessing behavioral health information. Future targets for improvement include personalization, equitable access, and reach beyond single institutions.