More Patient Portals, Less Patient Clarity

Uncertainty is one of the biggest barriers between patients and healthcare. When patients are confused about appointments, referrals, or next steps, they are less likely to get the care they need. 

But the negative effects of patient uncertainty don’t stop there. Uncertainty is like sand in the gears of healthcare systems, slowing down operations and hurting efficiency. As missed appointments, unresolved balances, and unscheduled referrals increase, staff spend more time fixing problems than focusing on care.    

Patient uncertainty hurts providers’ bottom lines and their ability to give patients the best care possible.  

Today, most patients are juggling multiple provider portals. For example, a patient might be managing four separate logins: one for their primary care provider, another for a gastroenterologist, one for their insurer, and one for their health savings account. Each portal sends its own reminders, results, and requests for information, all without any coordination.  

Add to that yet another portal for their pharmacy, and our patient in their 40s is overwhelmed with information and likely to miss an important message or not understand the next step to get the care they need.    

Patients are overloaded with information. They have more portals than ever. Yet they’re even less certain about where and how to find the information they need. They don’t know what actions they need to take to access the care they need. They are navigating their healthcare journey—already a complex task—in the dark.  

Providers often think that the best way to solve patient confusion is the addition of another tool. However, to solve fragmentation, health systems need to shift focus from individual interactions to orchestrating the larger patient journey.  

The Costs of Patient Confusion 

According to the Office of the National Coordinator for Health IT, 59% of patients report having multiple online medical records or patient portals, an increase from 50% just two years prior. But only 7% of those patients have a tool that consolidates those accounts for simplicity and ease of use.  

The increase in portals has a clear result: more messages. Patients are on the receiving end of reminders and requests from three, four, or even five different portals.  

A June study from the Journal of the American Medical Association found that messages from clinicians and staffers jumped by 24% from 2020 to 2025. Over those five years, patients received more than 3 billion portal messages, and the messages they sent to their providers more than doubled.  

But this onslaught of information hasn’t necessarily led to better care or more high-value, in-person interactions. Office visits only slightly increased during this period.  

Portals were designed to ease demand on phone lines and exam rooms, giving patients the information they needed more quickly and easily. Instead, this increase in messages has caused patient confusion and created more work for providers.  

When Steps Are Unclear, Patients and Providers Suffer 

Simply adding another tool or channel has not solved patient fragmentation. In fact, this has only increased confusion.  

What’s missing from patient communication is coordination.  

Both patients and providers need a clear view of the overall patient journey. But adding layers of tools too often obscures that journey rather than clarifying it. Without coordination, the missed appointments, mishandled referrals, and unpaid balances remain. And for staff, the volume of incoming calls increases as patients reach out more frequently to solve problems caused by uncertainty.  

Imagine that a primary care physician (PCP) refers a patient in their 40s for a routine yet essential colonoscopy. If the patient can’t find the referral in their PCP’s portal, or if the patient doesn’t know to check a brand-new portal for preparation instructions, then they are in danger of missing a potentially life-saving appointment. And in both scenarios, the next step that the patient should take in their health journey is unclear. 

As this example shows, patient fragmentation can create life-threatening barriers, including gaps in care, duplicated services, or medication errors. 

It also creates more work for staff. They are forced to reschedule appointments, juggle schedules thrown into chaos by no-shows, and respond to a growing number of patient questions. The increase in portal messages—and its resulting increase in patient confusion and calls—can contribute to exhaustion and burnout among physicians and staff.  

Orchestrating the Patient Journey to Improve Care 

Portals, per se, aren’t the problem. Research tells us that the use of portals can improve patient satisfaction, medication adherence, self-management of disease, and preventative care.  

The problem arises when healthcare systems don’t orchestrate the entire patient journey, step by step.  

To address fragmentation in real and life-changing ways, healthcare systems need to fundamentally shift how they think about the patient experience, focusing on the patient rather than the tool. 

Providers must understand how to orchestrate each patient’s journey. This means taking a big-picture view of the patient journey—beyond individual touchpoints—to gain a beginning-to-end understanding of how each patient experiences care.  

Orchestration requires systems and tools, like portals, to all work together. Providers need to break down data silos and coordinate communication so that patients receive the right information through the right channel at the right time.  

Shifting focus to the patient’s journey also means rethinking how healthcare measures ROI. Rather than evaluating ROI based on metrics of efficiency, providers need to focus on ROI metrics based on patient access. This includes data points like appointment completion, referral follow-ups, participation in preventative screenings, engagement after outreach, and reductions in care delays.  

This kind of big-picture thinking also improves the downstream effects of access. With this mindset shift, patients get earlier diagnoses and better adhere to medical instructions. Health systems see healthier patient populations and lower costs of care.  

To Fix Fragmentation, Focus on the Patient 

Portal usage is trending upward, and it will continue to grow. But if healthcare is going to truly fix fragmentation—if it is to truly increase access to care and make systems more efficient—then providers need to focus on orchestration.  

To make sure that patients have the clarity and certainty they need, healthcare systems need to shift focus away from individual tools and away from solely focusing on efficiency metrics. Instead, systems need to focus on the entire patient journey, making orchestration the lens through which they use tech tools such as portals.  

Bringing the focus back to the patient will benefit patients and systems alike, ensuring patients more easily get the care they need at the times when they need it the most.