Date of Award

Fall 2019

Document Type

Open Access Dissertation


Health Services and Policy Management

First Advisor

Melanie Cozad


Shared decision making (SDM) is a collaborative decision-making style where the patient and the physician are involved in the clinical decision-making process. The goal of this dissertation project was to examine the relationship between the patient portal of an electronic health record (EHR) and SDM.

The SDM process has three main components: information sharing, deliberation and decision making. Patients participate in SDM at varying levels: some patients may prefer to share information and deliberate but leave the final decision making to the provider while others prefer to participate in all the three components of SDM. The patient portal of an EHR provides a platform where patients can access their health information and maintain continuous interaction with their healthcare provider beyond the office visit. Additionally, the patient portal helps the patient overcome the issue of time constraints during the in-office visit as it provides a platform to communicate with their providers beyond the scheduled time allocated to the patient during their visit.

We utilized data from the Health Information National Trends Survey (HINTS) which is administered by the National Cancer Institute and ran a regression analysis to examine the relationship between the patient portal of an EHR and SDM. The relationship between the patient portal and SDM was examined across the three components of SDM across the total population and for patients with chronic disease or a preference sensitive condition. To measure SDM, we used a top box scoring approach.

Our study did not show a significant relationship between the patient portal and SDM. However, the relationship between SDM and immigrant status and level of education were significant. In conclusion, this project showed that participation in SDM goes beyond knowledge, which the portal provides, to empowering the patient to participate in their care.


© 2019, Gloria Esoimeme