Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Industrial Engineering

Committee Chair/Advisor

Dr. David M. Neyens

Committee Member

Dr. Kapil Chalil Madathil

Committee Member

Dr. Mary Beth Kurz

Committee Member

Dr. Katherine E. Law


The use of the Electronic Health Records (EHR) patient portal has been shown to be effective in generating positive outcomes in patients’ healthcare, improving patient engagement and patient-provider communication. Government legislation also required proof of its meaningful use among patients by healthcare providers. Typical patient portals also include features such as health information and patient education materials. However, little research has examined the specific use of patient portals related to individuals with specific diseases such as inflammatory bowel diseases (IBDs). IBDs are life-long, not curable, chronic diseases that can impact the whole population. Individuals with IBDs may have higher needs to acquire health information from their EHR portals to properly self-manage their health conditions. The research aims of the present dissertation are to understand the online health information-seeking behaviors of a target group (IBDs) of patients, the use of EHR patient portals, and the impact of design features of EHR patient portals on the usability and information communication for shared decision making.

Through this dissertation, I conducted four studies to address the above research aims. First, I identified how individuals with inflammatory bowel disease (IBD) used the internet for health information seeking, the factors impacting their use of the internet to obtain health information, and how they used the internet for health-related tasks. The purpose of this study is to get a general understanding of the online health information-seeking behaviors and to guide the study of health information presentation of EHR portals in the following research. Second, I examined what factors influenced an EHR patient portal user to believe that the portal is a valuable part of their health care. This part of the dissertation aimed to reveal the critical design factors that help design an EHR portal perceived as valuable in managing health. Third, I looked at how patients used EHR patient portals, what features of the portals facilitated their use and encouraged Shared Decision Making (SDM) and engagement in health management and what features acted as barriers to SDM and their engagement in health management. This part of my dissertation focused on a broad understanding of EHR portals usage by introducing more specific factors such as features of EHR portals. Fourth, I conducted an eye-tracking study to examine how information presentation methods and chatbots impact the use and effect of patient portals. This part of my dissertation built on the other studies within my dissertation and deepened the understanding of the influence of different EHR portal designs on their effectiveness and people’s willingness to participate in SDM.

The results of this dissertation contribute to the literature of understanding the information-seeking behaviors of IBD patients and the use of portals, as well as the design considerations of how to make a suitable EHR portal to support the information-seeking needs of IBD patients. The results of this dissertation can be used to guide building proper patient education materials to support their health information needs of their specific health condition, especially for individuals with chronic diseases that require a certain amount of self-management. Meanwhile, examining artificial intelligence (AI) based chatbots use in EHR portals reveals a potential path of AI use in healthcare, such as information acquisition and patient education. Designing good usable EHR may also facilitate the process of informing patients of the advantages and disadvantages of treatment plans for their disease and, therefore, may increase their willingness to participate in SDM.



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