During the height of the pandemic in 2022, a study revealed that, while three out of four people were offered patient portal access, only three and five actually used them.
That number has increased over the years. But, in 2025, another study found that less than half of surveyed patients logged in to their portal once a month, 33% used it less than once per month, and 16% never logged in at all.
This is leading many frustrated practice owners to throw their hands up in frustration and yell, “If patients don’t really care about them, why are we investing so much money in offering a portal?”
Today, we’re going to take a detailed look at the pros and cons of patient portals, so you can determine whether or not it’s time for your practice to invest in one or upgrade your current solution.
Patient Portals at a Glance: Pros Vs. Cons
Most patient portals are a mixed bag of benefits and challenges. Adoption is often on the slow side because patients are the first ones to feel the challenges.
But from the clinic’s perspective, here is a brief overview of the pros and cons of introducing a patient portal:
| Pros: What portals do well | Cons: What portals get wrong / cost you |
|---|---|
| 24/7 access to health records anytime | Low adoption among older, low-tech patients |
| Reduces inbound phone calls to staff | After-hours message overload for physicians |
| Faster prescription refill requests processed | Test results released before doctor review |
| Secure messaging with care teams | Security risks and phishing vulnerabilities |
| Easy appointment booking and self-service | Fragmented UX across multiple portal systems |
| HIPAA-compliant audit trails for activity | Admin burden: onboarding and password resets |
| Improves patient engagement and adherence | Risk of patient self-misdiagnosis, anxiety |
| Supports OpenNotes and Cures compliance | Accessibility barriers, language limitations |
Quick Recap: What a Patient Portal Does (And Doesn’t Do)
Simply put, this is the patient-facing layer of the EHR, giving them access to:
- Scheduling
- Messaging
- Lab/results review
- Refill requests
- Intake forms
- Billing/payment
On a very simple level, what is a patient portal from a customer service perspective? It’s an extension of your brand, and one of the most underrated touchpoints for your company.
What it is not is a replacement for administrative staff. Human intervention is still needed to manage your patient portal.
The Pros: What Patient Portals Get Right
Are the marketplace’s current patient portal solutions simply overrated? Or are we not communicating the benefits well to the average patient?
Properly leveraged, your patient portal should reduce your administrative burden by taking a number of time-sucking tasks off your plate, assuming you’ve been properly trained and fully understand how patient portals work and the tools at your disposal.
Here’s a glance at some of the things that most of them get right.
Pro 1: Patients get 24/7 access to their own records
One of the most important benefits of patient portals is 24/7 access to personal health information. Patients can review lab results, visit summaries, immunization records, and medication lists anytime, all without needing to call the front desk.
This is no longer a “nice-to-have.” Under the 21st Century Cures Act, giving your patients access to their records is now a requirement, not a bonus.
Pro 2: Fewer phone calls and front-desk interruptions
The patient portal can take between 30 to 50% of your front desk staff’s tasks off their plate. Or, if you’re a one-person show, it can take them off your plate, which would be an even bigger business impact.
However, the return on investment stretches beyond the hours saved. Having a strong patient portal can reduce no-shows, with portal users being 67% more likely to show up for appointments.
At the same time, one Reddit user said this type of scheduling lowers “barriers to scheduling for those that are autistic or struggle with social interaction.”
Pro 3: Faster prescription refills and form turnaround
A properly implemented patient portal can also ensure refill requests are routed directly to the chart, not through endless rounds of phone tag.
You can also reduce no-shows and get patients in the room faster by completing intake and consent forms before the visit.
Pro 4: Secure messaging that’s HIPAA-defensible
Now let’s talk about patient portal security.
We probably don’t have to tell you that, even though email and text exchanges can be tempting and convenient for the patient, they’re a dangerous game when it comes to compliance. On the other hand, a secure messaging portal is auditable, encrypted, and ideally tied to the patient’s chart.
Most leading patient portals (including Cerbo’s) automatically log messages to the patient’s record, keeping all your vital information in one place. More importantly, keeping it secure.
Pro 5: Better adherence, engagement, and chronic-care follow-through
A patient portal can help you create better outcomes, with data showing that portal users are more likely to adhere to their medication schedules. At the same time, you also help them follow along with chronic disease and KPI tracking.
This can be particularly beneficial for practitioners in the DPC, functional medicine, and concierge practice space who rely on heavy patient involvement with high-touch care plans.
Pro 6: Self-service scheduling, payments, and intake
Once again, if you’re a sole practitioner, you’re losing a considerable amount of time every week to these administrative tasks
The patient portal should also ease the administrative staff’s burden with simplified:
- Online appointment booking
- Card-on-file
- Statement payments
- Balance inquiries
The impact of these savings will be felt more in cash-based and a DPC patient portal.
The Cons: What Patient Portals Still Get Wrong
On the other hand, here are a few areas where portals are still ironing out the kinks.
Con 1: Adoption gap: Not every patient will use it
This is still not the best option for:
- Older patients
- Patients without reliable broadband
- Patients with limited English/ health literacy
- Patients with vision/cognitive disabilities
Traditional methods must still be in place for patients who meet these criteria.
Con 2: Portal-message overload and physician burnout
Since the pandemic, the number of portal inbox messages has spiked and has not decreased.
The sheer number of messages in the portal can be a death by a thousand papercuts, or burnout through a thousand clicks.
According to the American Medical Association:
- Physicians spend 2.32 minutes on the average patient portal message
- A 2-sentence message can require 10 minutes of clinical work
- Busy doctors may receive 20–40 messages per day
- This can add up to 60–90 minutes of unpaid after-hours work
This is why pajama time/ portal triage time is one of the most complained-about aspects of patient portals.
Con 3: Patients see results before the doctor reads them
Because of the 21st Century Cures Act, lab and imaging results may be available in your portal the moment they are released. This obviously creates a massive potential problem, as the patient can have the results before you do.
More terrifyingly, it’s possible that a patient will find out about life-altering news on their smartphone in a parking lot at 9 PM.
This is problematic, but preventable with:
- Provider workflows that pre-route critical results to a callback queue
- Patient education on what an unread/unreviewed result means
- Release-delay configuration, where state law and CMS rules allow
This is something that is manageable.
Con 4: Security risk: Phishing, credential theft, and breach exposure
Human users still remain the most vulnerable part of any patient portal security plan, particularly when it comes to phishing schemes.
In 2024 alone, over 170 million patient records were impacted by data breaches, a staggering increase from the mere 6 million in the year 2010.
Regarding patient portal attacks, Security Magazine recently profiled a breach that affected 126,000 patients in New Zealand and a much larger one in the US that affected 700,000 patients.
Con 5: Fragmentation: Patients juggle a portal per provider
You’re probably not the only practitioner the patient has, which means they might be logging into 45 different patient portals.
Simply put, this can lead to portal fatigue and patients abandoning their accounts. Now, you’re not just eliminating the phone calls that the portal was supposed to eliminate; you’re getting new ones as patients call in because they’ve forgotten their password or can’t find their results within your portal.
Larger practices can mitigate this by pursuing a unified records strategy with HL7 and FHIR integrations, while encouraging patients to use a single primary portal where possible.
For smaller and independent practices, this is partly out of your hands, as your portal has to compete with the ones used in bigger operations.
Con 6: Misinterpretation and self-diagnosis from raw data
One of the major problems with patient portals is that lab results are easily accessible, allowing them to read a flagged lab report without any context whatsoever, which can lead them to jump to conclusions or spiral. The same goes for impressions in imaging reports written for clinicians, not everyday people.
The best way to fight this is to provide plain language, summaries, or portal disclaimers about results. It also motivates you to provide faster commentary on abnormal results as they come in.
Con 7: Implementation, training, and ongoing admin cost
When you first envisioned your amazing patient portal, you might have been imagining a set-it-and-forget-it godsend for your business. But the reality is that managing the portal can sometimes seem as much work as the old-fashioned method. Somebody needs to “own” it. Somebody needs to handle enrollment, frequent password resets, and triage message routing rules.
The downside is that these tasks can be annoying and frequent, often taking the person right out of their workflow for the day with no warning.
The best strategy to mitigate this is to use a patient portal built into one of the top EHR systems, not a bolt-on third-party solution. This can automate enrollment intake and give you simple procedures for resetting passwords.
If this is going to take somebody out of the task they were doing before the request, at least they won’t have to leave the EHR to do it.
So, Should Your Clinic Invest In A Patient Portal?
We raised the issues above to flag them as potential issues, not to talk you out of getting a patient portal. The reality is that, yes, you should absolutely have one. Running a modern clinic without one is borderline impossible and untenable.
The question is, what type do you need?
If you’re a Direct Primary Care or membership practice
In this case, your portal is non-negotiable. Asynchronous messaging is a core part of your membership and your value proposition, and so is:
- Stored card on file
- Family/proxy access
- Simple in-portal billing, message-volume tool
If you’re running a DPC or membership-based practice, your portal is your competitive advantage.
If you’re a functional/integrative or specialty practitioner
In the functional medicine space, your portal will have to handle:
- Long intake forms
- Supplement plans/refill requests
- Lab integrations (Rupa, Genova, Vibrant)
- Care-plan delivery
It should work in perfect concert with any leading EHR for functional and integrative medicine.
If you’re a cash-based or concierge practice
When it comes to cash-based practices, portal-driven self-service for scheduling, payments, and intake is going to maintain your margins and make scaling possible.
FAQs
What are the disadvantages of patient portals?
As we covered above, the main disadvantages of a patient portal can be low adoption rates among certain patient populations, combined with the potential for messaging overload, as well as opening yourself up to security and phishing risks.
You can mitigate these problems by making sure you go with the best possible portal for your practice.
What are the benefits of having a patient portal?
When properly implemented and onboarded, the benefits of patient portals include the obvious operational benefits of fewer phone calls and faster refills. At the same time, the patient benefits from having access to their record and self-service scheduling through secure communications.
Are MyChart and a patient portal the same thing?
No, MyChart is actually a branded patient portal owned by Epic. Most large hospital systems on Epic use the MyChart portal.
On the other hand, DPC, functional, and independent practices typically use a smaller portal that’s part of their EHR or practice management software and built for their needs.
What are the security risks of using a patient portal?
Security risks are the same as any messaging portal in any business. However, the stakes are heightened when dealing with sensitive patient information and their financial information.
The key ways to mitigate these dangers are to properly train your staff and to be diligent. Provide in-app warnings about fishing schemes, and encourage your users to use strong passwords.
How Cerbo’s Patient Portal Addresses the Cons
If you’re running a DPC, functional/integrative, or EHR for cash-based practices, here’s how Cerbo’s patient portal handles the trade-offs above.
Clinicians can avoid message overload with customizable triage routing that lets MAs manage first-line responses, while every interaction automatically attaches to the patient chart for clean documentation. As for security, Cerbo features include MFA, role-based permissions, and a full audit trail, so you’re not sacrificing compliance for convenience.
You don’t need to add another tool to juggle. Our portal is built directly into Cerbo’s EHR. One single login, the same records, and no fragmentation.
See Cerbo’s portal in action on a real workflow.
Or, you can also schedule a Cerbo demo so you can ask the important questions.
