This resource is for health systems and clinicians to learn about shared access (also called proxy access) to online patient portals. Learn how individual clinicians and staff as well as health care systems can help to make this option more available to patients and care partners. And learn why shared access matters to patients and their care partners.

Shared access is when a patient grants someone they trust formal access to their patient portal. This creates a separate login for the care partner to access the patient’s portal account. Patients often choose to share access when someone else is helping them coordinate or manage their care, or would need to access their medical information in case of an emergency.

The people your patient chooses to share access with can, in most portals, view the patient’s medical information, schedule appointments, pay bills, request prescriptions renewals, and send messages to the care team.

Shared access is often referred to as proxy access. A patient portal proxy is not the same as a healthcare proxy and therefore does not give someone the legal authority to make healthcare decisions for your patient. Also, being a healthcare proxy does not give a care partner automatic access to someone’s patient portal.

Logging in as the patient may seem convenient, but it creates confusion for your team and threatens patient privacy. You will likely feel more secure exchanging messages and providing information with care partners who have been given shared access by your patient. By using shared access, you will know who you are communicating with and who your patient trusts with their private medical information.

Here are some ways clinicians can benefit from shared access:

  • Know who is sending messages. When care partners of adults log on to their patient portal using the patient’s credentials, it can be difficult for clinicians/staff to know who is sending a message. With shared access, you will know if the patient or a care partner (and which care partner) is sending the message.
  • Know that a trusted person is involved. Because the patient decides who can have shared access, clinicians/staff know they are sharing information with a trusted individual chosen by their patient.
  • Engage care partners better. With shared access, people who are assisting an adult patient with their care have easy access to their medical information to help support the plan of care.  They can interact with medical staff, order medication refills, and read notes from visits in order to stay up –to date on the patient’s health. They are also able to access information to share with other medical professionals in an emergency.

Here are some ways patients and care partners benefit from shared access:

  • Routine care coordination. Care partners can better help coordinate care, remind patients of appointments and follow-ups, and coordinate medications, especially for those patients with cognitive difficulties.
  • Share in the continuity of care. Care partners are often relaying information about your patient to other health professionals. Shared access allows them to support continuity of care around your plan for your patient.
  • Emergency situations. Care partners can easily access the patient’s medical information in emergency circumstances.
  • Filling in gaps. Care partners can learn more about what happens in visits they can’t attend and ask follow-up questions.
  • Options for privacy/control. In some systems, the patient or care partner can send a message to a clinician and choose whether the other person can see the message, allowing some degree of privacy control for the patient. Some systems also allow patients to broadly decide what type of information the proxy can see (clinical, administrative, or both).

For more details see Shared Access Toolkit: Patients & Care Partners.

  • Familiarize yourself with shared access at your health system. Find out if your health system allows for shared access between adults. If it doesn’t, let your health system leadership know you want that to happen. If it does, familiarize yourself and your staff with the process so that you understand what is required of patients and care partners.
  • Talk to your colleagues about shared access. Many clinicians and health care staff (even IT departments!) are unaware that shared access for adult patients is an option, or they have misconceptions about the practice of shared access. Education and awareness are important steps in increasing shared access at your health system.
  • Talk to your patients about shared access. Many adult patients and care partners don’t know that sharing access to their portal accounts is an option.
    • Inform patients when introducing the portal.
      When you/your staff sign up a patient for the patient portal, or introduce the patient portal to them, make sure that they are aware of the benefits of sharing access. You can share our Patient & Care Partner resource with them for more detailed information. We also have handout templates that can be adapted for your health system.
    • Engage care partners who are actively helping your patients.
      If you have a patient who comes to visits with someone else, or you know has someone else assisting them with their care, talk to them about shared access and make sure they know how to complete the steps. Again, handouts can help to communicate this information quickly.
    • Mention shared access when scheduling telehealth visits.
      When scheduling telehealth visits, ask if someone else will be joining and make sure they have information about shared access.
    • Be responsive.
      If a patient says during a visit that they would like to designate someone to have shared access, have a process for providing them with information or assistance.
  • Make sure the function exists. Your health system will need to confirm that adult-adult shared access is an option in your patient portal. If it is not, they will need to ask the EHR vendor to incorporate that function.
  • Make information easy to find. Your health system will need to make sure that information about shared access is on the organization’s website and in the patient portal. Your health system should partner with patients and care partners to develop patient-friendly language and information and determine how to make it most easily accessible in your context. See examples of health system webpages with information about shared access:
  • Use consistent terminology. While the most common names for this type of access are “proxy access” or “shared access,” there are other names as well. In addition, using the word “proxy” to describe online patient portal access makes people think of “healthcare proxy,” which is a completely different kind of proxy. It’s important for language about shared access to be easily understandable for patients.
  • Work with Patient/Family Advisory Councils (PFACs) and staff to refine the process for sharing access. Your health system can pull together a group of patients/care partners/staff to look at the steps required to assign shared access and discuss how the process can be made clearer and more efficient for patients. Ideally, there is an option for patients to share access through their patient portal, as well as an option for staff to assist patients with this process when they are in the clinic. Also make sure that patients can easily find out what to do if the care partner is not a patient at the same health system.
  • Get the word out to patients. Your health system’s communications team can partner with patients and care partners to create patient-facing materials such as posters and brochures and discuss outreach/education strategies. Templates to get started are available here.
  • Get the word out to staff. Your health system can make sure staff understand shared access and how it works at your organization. Hosting discussions and trainings, as well as providing materials like handouts and room posters are some ways that health systems can make sure staff are well informed. We also recommend a handout for clinicians with a list of guidelines or opportunities for discussing shared access with patients.