Patient Portals for Medical Practices: Benefits, Costs, and Implementation

“We have a patient portal. Nobody uses it.”

We hear this constantly from medical practices. They invested in portal technology—often because their EHR included it—but patient adoption stalled at 15-20%.

The problem usually isn’t the technology. It’s how the portal was implemented, promoted, and integrated into practice workflows. Patient portals can transform patient engagement and reduce administrative burden—but only if patients actually use them.

Here’s what medical practices need to know about patient portals: what they do, what they cost, and how to get patients to actually adopt them.

What Patient Portals Do (and Don’t Do)

Let’s start with realistic expectations.

What Portals Do Well

Secure messaging: Patients can ask questions without phone tag. Staff can respond when time permits. Everything is documented.

Appointment management: View upcoming appointments, request new appointments, cancel or reschedule existing ones.

Prescription refills: Patients request refills through the portal. Staff processes them without phone calls.

Lab and test results: Results available as soon as released. No waiting for a phone call.

Medical records access: Patients can view their health history, visit summaries, and care plans.

Bill pay: View balances and make payments online.

Form completion: Pre-visit forms, health histories, and consent documents completed before arrival.

What Portals Don’t Replace

Urgent communication: Portals aren’t for emergencies. Patients with urgent needs still need to call or go to urgent care.

Complex discussions: Some conversations require phone calls or visits. Portals are for routine communication, not diagnosis discussions.

Personal connection: Technology supplements the patient-provider relationship; it doesn’t replace it.

Phone entirely: Some patients will always prefer calling. That’s okay.

The Value Proposition

For patients:

Convenience (24/7 access)
Faster answers for simple questions
No phone hold times
Access to their own health information

For practices:

Reduced phone volume
Staff efficiency (respond when convenient)
Better documentation of patient communication
Improved patient engagement metrics
Meaningful Use / MIPS compliance support

EHR-Integrated vs. Standalone Portals

Most practices face this choice: use the portal that comes with their EHR, or implement a standalone solution.

EHR-Integrated Portals

Your EHR vendor provides a patient portal that connects directly to the EHR.

Examples:

Epic MyChart
athenahealth Patient Portal
eClinicalWorks Patient Portal
Cerner Patient Portal
Greenway Patient Portal

Advantages:

Seamless integration: Data flows automatically between portal and EHR
Single source of truth: No synchronization issues
Included cost: Often included in EHR subscription
Vendor support: One vendor for portal and EHR issues
Familiar interface: Staff already know the EHR

Disadvantages:

Limited customization: Portal looks and works how vendor designed it
Tied to EHR: Switching EHRs means switching portals
Feature limitations: May not have features you want
Patient experience: Some EHR portals are clunky

Standalone Portals

Third-party patient engagement platforms that integrate with (but aren’t part of) your EHR.

Examples:

Klara
Luma Health
Relatient
Solutionreach
Phreesia

Advantages:

Better patient experience: Often more modern, user-friendly design
More features: Advanced scheduling, payments, reviews, marketing
Customization: Configure to your workflows
EHR-agnostic: Keep portal if you switch EHRs
Best-of-breed: Choose the best tool for the job

Disadvantages:

Additional cost: Separate subscription
Integration complexity: Must connect to EHR (varying quality)
Multiple vendors: More relationships to manage
Potential sync issues: Data must flow between systems
Staff learning curve: Another system to learn

Which Should You Choose?

Choose EHR-integrated if:

Budget is primary concern
Your EHR’s portal is reasonably good
You need basic functionality
Staff bandwidth for new systems is limited
Integration reliability is paramount

Choose standalone if:

Patient experience is a priority
You need advanced features
Your EHR’s portal is poor
You’re likely to switch EHRs
You want a competitive advantage

The hybrid approach: Some practices use their EHR portal for clinical functions (results, records) while using standalone tools for scheduling and communication. This can offer best of both worlds but adds complexity.

Features Patients Actually Use

Portal features vary, but usage patterns are consistent. Some features drive adoption; others gather dust.

High-Usage Features

Appointment scheduling/management: The #1 reason patients log in. If they can book, reschedule, and view appointments, they’ll use the portal.

Prescription refills: Quick, convenient, no phone call. High value for chronic disease patients especially.

Lab results: Patients want to see results immediately. This drives consistent portal engagement.

Secure messaging: For simple questions—appointment confirmation, medication questions, referral status.

Bill pay: Convenient payment option. Drives engagement and improves collections.

Medium-Usage Features

Medical records: Patients access when needed (new provider, insurance issue) but not regularly.

Visit summaries: Reviewed occasionally, helpful for reference.

Pre-visit forms: High usage when required, otherwise ignored.

Educational content: Depends heavily on quality and relevance.

Low-Usage Features (Often)

Health tracking/goals: Unless actively prompted by care team.

Social features: Rarely compelling in a medical context.

General health content: Patients find this elsewhere.

Complex care plan tools: Often too complicated for engagement.

The Engagement Lesson

Focus your implementation and promotion on high-value features. Don’t overwhelm patients with everything at once. Lead with appointment management and results—features that provide clear, immediate value.

Implementation Considerations

Implementing a patient portal isn’t just a technology project. It’s a workflow change that affects every patient interaction.

Pre-Implementation Planning

Define goals: What specific outcomes do you want? Reduced phone volume? Better patient satisfaction? MIPS compliance? Clear goals guide decisions.

Assess current state: How do patients currently communicate? What pain points exist? Where does staff spend time that portal could reduce?

Choose features to launch: Start with high-value features. Add others over time. Don’t overwhelm patients or staff with everything at once.

Plan workflows: How will messages be handled? Who responds? What response time is expected? What happens after hours?

Technical Implementation

Integration setup: Ensure solid connection to EHR if using standalone. Test data flow thoroughly.

Single sign-on: If possible, simplify login. Password fatigue kills adoption.

Mobile optimization: Most portal access is mobile. If mobile experience is poor, adoption will be poor.

Security configuration: Balance security with usability. Too many barriers prevent adoption.

Workflow Changes

Message triage: Establish who handles what types of messages. Route appropriately.

Response time expectations: Set expectations with patients. “We respond within 2 business days” is better than no commitment.

Escalation procedures: What happens when a message indicates an urgent issue?

Integration with phone: Patients may still call. Staff should reference portal option but not force it.

Staff Training

Technical training: How to use the portal from the staff side.

Workflow training: How portal changes their daily work.

Patient education training: How to promote portal to patients.

Troubleshooting: Common patient issues and how to resolve them.

Learn more about practice technology

Cost Factors

Portal costs vary significantly based on your approach.

EHR-Integrated Portal Costs

Often included: Many EHRs include basic portal functionality in their subscription.

May be additional: Some EHRs charge extra for portal features or higher usage tiers.

Hidden costs:

Staff time for implementation
Training time
Ongoing message handling labor
Support time for patient issues

Standalone Portal Costs

Subscription models: Most charge monthly per-provider or per-practice.

Typical ranges:

Basic platforms: $200-500/month
Mid-tier platforms: $500-1,000/month
Enterprise platforms: $1,000-3,000+/month

What affects pricing:

Number of providers
Number of patients
Features included
Integration complexity
Support level

Implementation costs:

Setup fees: $500-5,000
Integration: $1,000-10,000 depending on complexity
Training: $500-2,000
Data migration: Varies

ROI Calculation

Portal ROI comes from:

Reduced phone volume: If each phone call costs $3-5 in staff time, and portal reduces calls by 20%, calculate savings.

Fewer no-shows: Online scheduling and reminders reduce no-shows. Each avoided no-show has real value.

Faster payments: Online bill pay improves collections and reduces billing follow-up.

Staff efficiency: Time saved on routine questions can be redirected to higher-value work.

Patient retention: Better engagement may reduce patient attrition.

Example calculation:

Factor	Estimate
Reduced phone calls	50/week × $4 = $200/week
Avoided no-shows	3/week × $75 = $225/week
Improved collections	$500/month
Monthly value	$2,200
Portal cost	$600/month
Net benefit	$1,600/month

Your numbers will vary, but the math often works—especially for practices with significant phone volume.

Driving Patient Adoption

The best portal in the world is worthless if patients don’t use it.

Enrollment Strategies

In-office enrollment: The most effective method. Have staff help patients set up accounts during visits.

Enrollment stations: Tablets or kiosks in waiting area for self-enrollment.

Email invitations: Send invitations with clear value proposition and easy setup.

Text-based signup: SMS links for mobile-first enrollment.

Promotion materials: Posters, handouts, website information explaining benefits.

Overcoming Barriers

“I’m not tech-savvy” Offer in-person help. Show them how easy it is. Start with one simple task (view results).

“I prefer to call” Don’t force it. Emphasize that portal is an additional option, not a replacement. Some patients will never use it—that’s okay.

“I don’t check it” Enable email/text notifications when new information is available. Bring patients to portal during visits.

“The password is too complicated” Simplify if possible. Help with password reset. Consider biometric login for mobile.

“I forgot my password” Make password reset easy and self-service. Train staff to help quickly.

Building the Habit

Require it for something: Pre-visit forms only through portal. Results released to portal first. Required elements drive initial login.

Reward early engagement: First few interactions set the pattern. Make them easy and valuable.

Reference it constantly: “That information is in your portal” becomes part of every interaction.

Send meaningful notifications: Don’t spam. Notify only for important things patients care about.

Make it about them: The portal is for their convenience, not yours. Message accordingly.

Measuring Adoption

Track these metrics:

Enrollment rate: % of patients with portal accounts
Activation rate: % who have logged in at least once
Active users: % who logged in last 30/60/90 days
Feature usage: Which features are actually used
Message response time: How quickly staff responds
Patient satisfaction: Portal-specific feedback

Benchmarks:

Enrollment should exceed 60%
Active monthly users should reach 30-40%
If numbers are lower, investigate barriers

Security and Compliance

Patient portals handle protected health information. Security isn’t optional.

HIPAA Requirements

Access controls: Only patients access their own data. Authentication must be secure.

Encryption: Data encrypted in transit and at rest.

Audit logging: Track who accesses what and when.

Breach procedures: Plans for handling security incidents.

BAAs: Business Associate Agreements with portal vendors.

Security Best Practices

Multi-factor authentication: Require for portal access (most do by default).

Session timeouts: Automatic logout after inactivity.

Password requirements: Balance security with usability.

Failed login lockouts: Prevent brute force attacks.

Device management: Consider device-based authentication.

Vendor Assessment

Before selecting a portal vendor, verify:

HIPAA compliance attestation
SOC 2 certification
Encryption standards
Data center security
Breach notification procedures
BAA availability

Learn more about healthcare cybersecurity

Getting Started

If you don’t have a patient portal—or yours is underperforming—here’s a starting path:

Audit current state: What do you have? What’s the adoption? What are the barriers?
Define goals: What would success look like? Reduced phone calls? Higher patient satisfaction?
Evaluate options: Is your EHR portal adequate? Would a standalone solution better serve your needs?
Plan workflows: How will you handle messages? What are response time expectations?
Train staff: Everyone needs to understand the portal and promote it consistently.
Enroll patients: Active, consistent enrollment efforts—not passive “it exists.”
Measure and improve: Track metrics, identify barriers, continuously improve.

Need Help With Patient Portal Strategy?

At MedTech Consulting, we help medical practices implement and optimize patient portals—whether that’s getting more from your existing EHR portal or evaluating standalone alternatives.