LAUSR

BACKGROUND Patient portals have been introduced in many countries over the last ten years, but many health information managers still feel they have too little knowledge of patient portals. A taxonomy can help them to better compare and select portals. This has led us to develop the TOPCOP taxonomy for classifying and comparing patient portals. However, the taxonomy has not been evaluated by users. OBJECTIVE To evaluate the taxonomy's usefulness to support health information managers in comparing, classifying, defining a requirement profile for, and selecting patient portals, and to improve the taxonomy where needed. METHODS We used a modified Delphi approach. We sampled a heterogeneous panel of thirteen health information managers from three countries using the criterion sampling strategy. Four anonymous survey rounds with qualitative and quantitative questions were conducted online. In round one, the panelists assessed the appropriateness of each dimension and we collected new ideas to improve the dimensions. In rounds two and three, the panelists iteratively evaluated the taxonomy that was revised based on round one. In round four, the panelists assessed the need for a taxonomy and the appropriateness of patient engagement as a distinguishing concept. Then they compared two real portals with the final taxonomy and evaluated its usefulness for comparing portals, creating an initial requirement profile, and selecting patient portals. To determine group consensus, we applied the RAND/UCLA Appropriateness Method. RESULTS The final taxonomy consists of 25 dimensions with 65 characteristics. Five new dimensions were added to the original taxonomy, with eight characteristics added to already existing dimensions. Group consensus was achieved on the need for such a taxonomy to compare portals, on patient engagement as an appropriate distinguishing concept, and on the comprehensibility of the taxonomy's form. Further, the consensus was achieved on the taxonomy's usefulness for classifying and comparing portals, assisting users in better understanding portals, creating a requirement profile, and selecting portals. This allowed us to test the usefulness of the final taxonomy with the intended users. CONCLUSIONS The TOPCOP taxonomy aims to support health information managers in comparing and selecting patient portals. By providing a standardized terminology to describe various aspects of patient portals independent of clinical setting or country, the taxonomy will also be useful for advancing research and evaluation of patient portals. CLINICALTRIAL