The Office of the National Coordinator for Health Information Technology Patient Engagement Playbook


About this playbook

The Patient Engagement Playbook is a tool for clinicians, health care practice staff, hospital administrators, and others who want to leverage health IT — particularly electronic health record (EHR) patient portals — to engage patients in their health and care.

Why the focus on patient engagement? Because engaged patients have the knowledge, skills, ability, and willingness to manage their health and care and to act on clinicians’ recommendations. Practices that invest in health IT for patient engagement can expect returns in the form of better outcomes and lower costs.

When selecting an EHR vendor, keep patients in mind.

Before you contract with an EHR vendor, be sure to research the EHR market (including competing vendors, products, and services) and make a priority list of features you want in your EHR.

Keep in mind that features supporting patient engagement, like self-scheduling, are the most effective ways to encourage portal adoption.1 Many patients — especially those under 40 — specifically seek out health care practices that use advanced health IT for communication and data management.2

Two people visiting a patient portal on a desktop computer

Health care practices across the country are already seeing the benefits of EHR patient portal implementation on patient engagement and beyond. The rewards are real: more informed, involved patients; more effective delivery of care; and reduced burden on office staff. But the barriers are real, too: cumbersome enrollment; clunky interfaces; reluctant patients and office staff; and questions of privacy and security. It will take years to address all of the pain points, but transformation is underway.

How to use the Playbook

In this playbook, we demystify patient portals and describe how you can make them work for you and your patients.

If your practice is just getting started with a patient portal, use the Playbook to learn how to promote it and establish processes that drive adoption including how to:

  • Make enrollment easier on your practice (1.1, 1.2)
  • Promote the portal and register patients in the office (Chapter 1 graphic, 1.3)
  • Educate patients about the portal and include it in visit summaries (1.4)

If your practice has already established a patient portal, use the Playbook to get ideas and tips for establishing features and policies that streamline and improve care — such as:

  • Communicate with patients by email and share notes through the portal (2.2, 2.3)
  • Navigate proxy access with patients and their caregivers (4.1)
  • Create a plan for integrating patient-generated health data into your practice (5.1)
  • Build goodwill for the portal among clinicians and staff (1.4)
  • Activate features like online booking (2.1)
  • Set up an efficient workflow for collecting family health histories (5.2)

How to use the Playbook. Full description below.

We’ve compiled best practices and home-grown solutions from innovative clinicians, practice administrators, and health systems around the country.

We’ve also told their stories in “From the field” examples scattered throughout the Playbook. The highlighted organizations stand out as pioneers — they’ve piloted unique programs that leverage health IT, shown how using health IT strategically can produce results, and earned national attention from the press and fellow industry leaders.

Each “From the field” example sheds light on what it means to put the Playbook into practice. There’s much to learn from analyzing these bright spots and scaling their success. Even a few small changes in your practice and patient portal implementation can lead to meaningful improvements in portal adoption, care delivery, and health outcomes.

Every day, clinicians and practices embrace new technologies, discover ways to improve care, and find opportunities for meaningful patient connection. As health IT and health care delivery evolve, the Playbook will evolve too. Over time, we’ll update it to include a broader range of tried-and-true strategies for involving patients in their health and care.

Why a playbook?

Playbooks aren’t static instruction manuals — they’re always-evolving sets of strategies and approaches. Good coaches update their playbooks constantly, and each iteration reflects new, innovative solutions to shifting circumstances.

This playbook is an important tool for our mission to help clinicians and their patients adopt and adapt to patient portals and patient-generated health data. We hope you’ll use it in a way that works for you and your practice.

For example, you may want to:

  • Review patient portal benefits with office staff, so they can share them with patients
  • Focus on one chapter at a time — discuss lessons during team meetings, apply best practices in the workplace, and have ongoing conversations about what works and what can be improved
  • Use Playbook language on your website or Facebook page to let patients know how they can use the patient portal to participate in their care

About patient portals

Patients like portals.

In 2017, half of Americans were offered access to an online medical record. 8 in 10 individuals who accessed their record reported it was both easy to understand and useful. 3

The Centers for Medicare & Medicaid Services (CMS) launched Meaningful Use objectives to encourage clinicians and practices to use EHR technology effectively — to improve patient care and outcomes. 4 , 5 For office-based Medicare clinicians, Meaningful Use will soon be replaced by Advancing Care Information under the proposed Quality Payment Program.

Clinicians and practices must meet Meaningful Use objectives to qualify for CMS’s EHR Incentive Programs and the upcoming Quality Payment Program. For example, Meaningful Use sets goals for clinicians and practices to:

In addition to financial incentives, portals can add up to big benefits in patient care. For patients with chronic diseases, engagement in patient portals has been associated with improvements in disease management. 6 Portals can also improve preventive care. Patients with portal access to screening recommendations — like when to get their next mammogram or colonoscopy — are more likely to follow through on these recommendations. 7

Ultimately, patient portals can contribute to:

  • Reduced call volume
  • Improved responsiveness to patients’ needs
  • Lower utilization of health services
  • More effective care
  • Cost savings 8

Patient portals hold enormous potential to improve patient care and practice workflow. We’ve created this playbook to help you realize it — and build an effective digital strategy for patient engagement.

Terms to know

Use this glossary, adapted from the Center for Healthcare Quality and Payment, to help establish a common language with all stakeholders.

Electronic health record (EHR). An EHR — also known as an electronic medical record or EMR — is an electronic system that clinicians use to document patients’ medical and health information. A patient’s EHR may include demographic data, progress notes, medications, vital signs, medical history, immunizations, lab results, and radiology reports. Patients don’t access their own EHR.

Patient portal. A patient portal is a secure website where patients can access their medical history and other health information stored in the EHR. Using the portal, patients can typically complete forms online, communicate with clinicians, request prescription refills, pay bills, review lab results, and schedule appointments.

Help us improve this Playbook

Best practices start with clinicians and administrators like you. We want to learn more about your experiences and hear your suggestions. Tell us what’s working and what isn’t. Have you successfully boosted portal adoption in your practice? Do you have a promising product solution?

As you discover new ways to navigate patient portals, EHRs, and other health IT solutions, let us know. We update the Playbook regularly with new patient engagement strategies and real-world examples. A good playbook is never complete: it evolves and keeps getting better — but it’s only as good as the people who use it. Please send us your suggestions, questions, and strategies so we can add to this tool and improve the patient experience.


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Content last updated on: May 31, 2019