How Health and Digital Literacy Shape Portal Use

The researchers wanted to see how well people with varying levels of health literacy and eHealth literacy could get into and use patient portals. They noted that navigating digital tools and grasping medical details are two separate skills. Even though the two skills often blend together, many past studies treat them as the same thing. This makes it hard to know whether each skill matters at different points of portal interaction.

To answer the question, the team performed a systematic review. They combed through PubMed, Scopus, CINAHL, PsycINFO, Web of Science, and Embase from the start of each database up to March 2026. Only English articles and gray literature that focused on adult users of real portals were kept. Participants had to have been tested for health or eHealth literacy with a validated tool, and the studies had to report a numeric link between those scores and how often or in what way people accessed the portal.

The final picture that emerged shows that health literacy and eHealth literacy are each tied to different portal behaviors. People with higher health literacy tend to log in more often and explore broader features, while strong eHealth literacy often predicts successful use of specific tools like appointment scheduling or test result viewing. The review also highlighted gaps where the evidence is thin, especially for rare portal functions and for older adults.

In short, the findings suggest that portal designers should not assume a single literacy level covers all needs. Tailoring instructions, simplifying navigation, and offering targeted support can help users regardless of whether they struggle with general health concepts or digital tools. The study underscores the importance of measuring both types of literacy when planning portal improvements.