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Maximising patient portal engagement in older people

   Norwich Medical School

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  Dr Zarnie Khadjesari  No more applications being accepted  Competition Funded PhD Project (UK Students Only)

About the Project

Patient portals consist of a website that links to a patient’s medical records and provides access to information and functionality such as test results, appointment bookings, repeat prescriptions and secure messaging with healthcare professionals. People over 65 are the highest users of healthcare services: they suffer from more ill health, particularly long-term health conditions. While people aged over 65 have found portals helpful, they are less likely to use them than younger people. This PhD project aims to empower over-65s and their carers to more fully engage with portals, enabling them to better self-manage and capitalise on portal benefits. It also explores the resource implications of strategies to improve engagement to support decision making.  

The project will be conducted at three hospitals in the East of England which have used portals for different durations. 

Aim: To understand what successful engagement with portals looks like, how the environment supports or hinders implementation and how best to maximise engagement in adults over 65 or their carers. 


1. To map the context of the portals, by describing the portals, their use, delivery and perceived benefit  

2. To understand successful engagement with the portals, through illustration of patient/carer journeys exploring how the portal is used, what is considered best-practice use of the portal, what impact this has on other services and how this differs from existing pathways into the service. 

3. To develop an engagement strategy with associated cost to inform an implementation blueprint for advising other hospitals on how to best to support older people to use patient portals.  

Research methods include qualitative approaches, such as interviews, workshops, document analysis and observation, combined with quantitative analysis of portal usage data and costing of strategies.  This is an exciting opportunity to develop strong implementation skills, supporting adoption of research into making a difference. 

Funding Notes

This PhD project is a Faculty of Medicine and Health Sciences competition for funded studentships. The studentships are funded for 3 years and comprise UK tuition fees, an annual stipend of £15,609 (2021/22 rate) and £1,000 per annum to support research training. International applicants (including EU) may apply but are required to fund the difference between UK and International tuition fees (details of tuition fees can be found on our website


i) Khadjesari Z, Houghton J, Brown T, Stevenson F, Lynch J. Contextual factors that impact the implementation of patient portals with a focus on older people in acute care settings: a scoping review. JMIR IN PRESS
ii) Amato MS, El-Toukhy S, Abroms LC, Goodfellow H, Ramsey AT, Brown T, Jopling H, Khadjesari Z. Mining Electronic Health Records to Promote the Reach of Digital Interventions for Cancer Prevention Through Proactive Electronic Outreach: Protocol for the Mixed Methods OptiMine Study. JMIR Res Protoc. 2020 Dec 31;9(12):e23669.
iii) Khadjesari, Z., Boufkhed, S., Vitoratou, S. et al. Implementation outcome instruments for use in physical healthcare settings: a systematic review. Implementation Sci 15, 66 (2020).
iv) Hull L, Goulding L, Khadjesari Z, Davis R, Healey A, Bakolis I, Sevdalis N. Designing high-quality implementation research: development, application, feasibility and preliminary evaluation of the implementation science research development (ImpRes) tool and guide. Implement Sci. 2019 Aug 14;14(1):80.
v) Khadjesari Z, Stevenson F, Toner P, Linke S, Milward J, Murray E. 'I'm not a real boozer': a qualitative study of primary care patients' views on drinking and its consequences. J Public Health. 2019 Jun 1;41(2):e185-e191.
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