Patient Portal & EHR Redesign

Most health appointments depend on two pieces of software: the record system that clinicians and staff use to document, order and coordinate care, and the view of that record that patients and carers open for themselves. Redesigning either is different from restyling it. The change reaches what staff do during a shift, what patients see and when, and how information moves between organisations.

What it covers

An electronic health record (EHR) is a digital version of a patient's paper chart. The US Office of the National Coordinator for Health IT (ONC) describes it as information that providers collect and maintain over time, which authorised professionals across organisations can create, manage and review. A patient portal is the patient-facing counterpart: a secure website or app showing part of that record, often with functions such as results or messaging. A 2024 ONC data brief reports that about 77 percent of US individuals were offered online access to their records and about 65 percent accessed them.

Interoperability, the secure exchange of health information between authorised systems and users, joins the two. In the United States, the rule implementing the 21st Century Cures Act calls for standardised application programming interfaces (APIs), the connections that let apps retrieve record data, and restricts information blocking, meaning practices likely to interfere with access to that information unless an exception applies. Australia's My Health Record is a central repository; a December 2025 report says most pathology reports have been visible to patients on upload since October 2025.

Who uses it

• Clinicians use the EHR to record findings, review results and place orders (enter test or treatment requests directly), often switching between many patients and tasks.
• Patients and carers use the portal, sometimes through proxy access, where a carer acts for the patient. A 2026 review of 52 studies on older adults found carers often use shared passwords or formal proxy accounts, and that people want finer control than all-or-nothing.
• Administrators and system managers configure the software, run scheduling and carry out upgrades.

What drives the design

One tension defines this domain. A clinical workflow, the sequence of tasks, people and information involved in delivering care, has to get simpler without becoming less safe. Simplifying is the reason for the work; safety is the constraint on how.

That is why redesign differs from a reskin. The Agency for Healthcare Research and Quality (AHRQ) hosts a toolkit for organisations that must redo how work is organised around new health IT such as EHRs, decision support and order entry, and notes that weak usability can cause errors or cancel out promised efficiency gains.

The problems recorded in a 2025 scoping review of 28 studies suggest four aims: fewer steps and clearer labels for frequent tasks; information gathered where a decision is made, not scattered across systems; less duplicated documentation; and fewer interruptions from task switching and alerts. A small UK feasibility study in two community mental health teams removed duplicate questions and pre-filled forms from earlier data. Its authors report about a 41 percent drop in form completion time, from a small sample.

On the patient side the aim is fewer barriers to signing in and carrying on. The older-adults review lists login difficulty, navigation, small type and cluttered pages as barriers. A 2026 analysis of 2024 US survey data found significant differences in being offered access by sex, age, income, education and rural residence.

Where the risks and constraints are

• Safety of the change itself. ONC's SAFER Guides are self-assessment tools for safer EHRs; the 2025 revision covers configuration, validation and maintenance, including testing after major upgrades.
• Alerts. Changing which alerts appear is a safety decision, not a layout one; the scoping review reports that clinicians often override pop-up medication alerts.
• Staff habit. A changed screen means relearning a familiar task; the UK study's authors concluded that changes built with clinical staff can improve use.
• Unequal use. Wider access does not mean equal use, and shared access raises privacy questions.
• Rules that set timing. Release rules differ by country and change over time.
• Thin evidence. Most studies cited here are small.

Where to read next

• Clinical vs Patient Interfaces: why one record needs two screens, and how release timing changes what a patient meets first.
• Health Literacy & Plain Language: wording results for someone worried or unwell.
• Trust, Ethics & Safety: alert fatigue, wrong-patient errors and accountability for a change.
• Accessibility & Regulation: the standards a portal or record system must meet.
• UX Patterns for Health: reusable answers for forms, confirmations and errors.
• Process & Research: testing a redesign with the clinicians and patients who will use it.

Related Showcase card

• Humanising the number - the one Patient portal & EHR domain card built so far - a lab result shown before a clinician has explained it.