Parental Access to Adolescent Online Healthcare Portals: Benefits, Problems, and Barriers

Objective Online healthcare portals provide access to electronic health information and support clinical communication. Almost no studies have examined perspectives on parental portal access. We aimed to characterize parental and adolescent perspectives on parental portal access. Methods Semi-structured interviews with 51 dyads of parents and adolescents (102 total interviews). We stratified sampling for equal proportions of adolescents with and without chronic illnesses. We analyzed interview transcripts using thematic analysis. Results Parents and adolescents identified several benefits of parental portal access: improving understanding and access to information; supporting parents in managing adolescents' health and logistics; and supporting parents in teaching adolescents about their health. Parents and adolescents identified the following problems: threatening the adolescent's privacy; creating or exacerbating tension within the family; struggling to understand medical information; and creating emotional distress for parents. Parents described the following barriers to portal use: difficulties with enrollment and maintaining access; interface challenges; lack of awareness; and lack of interest. Some parents preferred to maintain access after their child was legally an adult. Although the portal has the potential to support collaborative care management between parents and adolescents, few parents use this tool collaboratively with their adolescents. Parents and adolescents identified multiple benefits, problems, and barriers to parents accessing the adolescent portal. Parents need sufficient access to health-related information in the portal to help them manage their adolescent's health and illness, especially for adolescents with chronic illness. Future efforts could better leverage the portal as a way of supporting collaboration in care between parents and adolescents. Conclusion Portals offer several potential benefits to parents and adolescents. However, these benefits are impeded by technological limitations and lack of engagement of the adolescent.