The NIH in Understanding the Risks and Benefits of a Patient Portal Configured for HIV Care: Patient and Healthcare Professional Perspectives outlines that the risks accompanied by patient portals include:
Standard email systems can be prone to potential risks like interception, phishing, and unauthorized access, which are concerns when dealing with sensitive patient information.
However, encrypted email solutions like Paubox offer a secure alternative to standard email systems. Paubox integrates into existing email workflows, ensuring that both providers and patients can send and receive HIPAA compliant messages without the need for additional software or training.
The implementation of patient portals involves significant costs, including software acquisition, staff training, and ongoing technical support. According to the HIMSS Greater Kansas City Chapter, in an article titled Patient Portal Enrollment and Engagement Rounds on Inpatient Units, "Having dedicated staff prevented additional responsibility on unit staff to educate and support the enrollment of admitted patients." This highlights that integrating patient portals into the healthcare system would need additional staff.
The same sources noted that "Over 50% of survey respondents said that the portal was never discussed with them, or they were unsure if it was ever discussed with them." This suggests that beyond financial considerations, successful portal implementation requires proactive communication strategies. Moreover, policy changes, billing models, and additional infrastructure will be necessary to manage the growing message volume effectively.
According to a study from BMC Health Services Research, the cost of providing email communication for 1,000 consultations annually was approximately $19,930, with costs decreasing as the volume of consultations increases. The low cost can be attributed to the minimal overhead involved when using existing email systems, especially when administrative tasks are automated. With email-based services, there are no significant start-up costs beyond the necessary infrastructure, making it an accessible option for healthcare organisations seeking to reach patients remotely.
The same study notes that, “studies of email-based telemedicine have shown that some roles – namely administrative and supervisory – are more automation-friendly than clinical roles. Purpose-written email systems – through automation – can reduce or eliminate these roles,” thus reducing costs.
Platforms like Paubox further enhance the affordability of email communication by providing secure, HIPAA compliant email services. Paubox does not require additional infrastructure or significant setup costs, as it works with existing email systems. This lack of complex hardware or software requirements means healthcare organizations can start using secure email without the need for expensive investments in separate telemedicine platforms.
Read also: 6 major benefits of using healthcare email in your practice
According to HIMSS, "Patient access to online health information has become an essential component of healthcare delivery in the digital age; 90% of healthcare organizations offer patients access to an electronic patient portal." Despite this widespread availability, adoption remains a challenge. The same source highlights that "in a national cross-sectional survey, more than 50% of survey participants were not portal users."
To improve engagement, healthcare organizations have implemented dedicated portal enrollment and engagement (PEE) rounds. This initiative ensures that hospitalized patients and their families receive direct support in understanding the portal's benefits and enrolling in the system. HIMSS emphasizes that "bringing portal support directly to the bedside eliminated the families' need to inquire about portal registration; moreover, if a family is unaware of the portal and its benefit, they may not ask about the registration process."
According to JMIR Publications, patient portal messaging has led to an increased clinician workload, particularly in primary care settings, where optimization efforts are most needed. The ratio of patient count to clinician count and messages per clinician has steadily risen, indicating a growing burden on healthcare providers. Primary care physicians experience the heaviest per-clinician messaging workload, generating the largest number of messages annually. Meanwhile, nurse practitioners (NPs) and physician assistants (PAs) in primary care, despite being fewer in number, face disproportionately high messaging loads.
The study further outlines that most clinician messages (93.2%) are sent during standard working hours (7 AM – 5 PM), with a peak period around noon (17.3%). However, 5.94% of messages are sent after hours (5–11 PM), demonstrating that some clinicians continue their workload beyond regular shifts to keep up with patient communication demands. Additionally, research shows that 24% of electronic health record (EHR) work occurs outside clinical hours, further contributing to physician burnout.
According to ScienceDirect’s systematic review,, “During a six-week period, two pediatricians estimated spending an average of 30 minutes per day responding to emails. While this suggests a manageable time commitment, the adoption of email communication remains inconsistent across the healthcare sector.
Despite its challenges, email communication has demonstrated potential in enhancing chronic disease management by improving continuous patient communication and increasing flexibility in handling non-urgent issues.”
Learn more: HIPAA compliant email
Yes, encrypted email services like Paubox provide secure, HIPAA compliant communication for healthcare purposes.
Yes, email is often considered more accessible and convenient.
No, patient portals can be complex and challenging for some users, particularly older individuals or those with limited tech skills.
No, email systems can often integrate seamlessly into existing workflows.