Objective To describe the evolution, use, and satisfaction of a patient Web site with a shared medical record between patients and providers at Group Health Cooperative, a mixed-model health care financing and delivery organization based in Seattle, Washington.

Design and Measurements A retrospective, serial, cross-sectional study of the adoption and use of a patient Web site (MyGroupHealth) from 9/2002 through 12/2005 and a mailed satisfaction survey of a random sampling of 2,002 patients who used the patient Web site in August 2004.

Results As of December 2005, 25% (105,047) of all Group Health members had registered and completed an ID-verification process enabling them to use all the available services on MyGroupHealth. ID-verification was more common among patients receiving care in the Integrated Delivery System (33%) compared to patients receiving care in the network (7%). As of December 2005, unique monthly user rates per 1,000 adult members were the highest for review of medical test results (54/1000), medication refills (44/1000), after-visit-summaries (32/1000), and patient-provider clinical messaging (31/1000). The response rate for the patient satisfaction survey was 46% (n=921). 94% of survey respondents were satisfied or very satisfied with MyGroupHealth overall. Patients reported highest satisfaction (satisfied or very satisfied) for medication refills (96%), patient-provider messaging (93%), and medical test results (86%).

Conclusions Use and satisfaction with MyGroupHealth were greatest for accessing services and information involving ongoing, active care and patient-provider communication. Tight integration of Web services with clinical information systems and patient-provider relationships may be important in meeting the needs of patients.