Pediatric Patient Portal Check-In

A concept case study (mock research study, 1-week sprint)

The goal: increase pre-check-in completion in a MyChart style app and reduce day-of-appointment friction

Snapshot

Users

Caregivers & teens (14+)

Context

EHR-connected patient portal
Proxy access
Privacy constraints

Methods

Survey (n=107)
Thematic analysis
Journey/flow mapping
Low-fi concepts

Deliverables

Insights + opportunity areas
Recommendations
Validation Plan

The Problem.

Pediatric check-in is high friction for caregivers & teens, creating delays, stress, and incomplete intake data.

This costs both providers and patients money, time, and health.
A grayscale image of a mother sitting on a couch and holding an infant looking off to the right.

Why It Matters

Providers don't get paid. Patients take on unnecessary out-of-pocket costs.

Incomplete portal check-in leaves providers vulnerable to delayed billing, referrals, etc. This translates to delayed care for patients, a need for follow up appointments (with additional co-pays) or even denial of insurance coverage.

As a therapist working with children with chronic conditions, and their families, I heard about (and experienced) these disruptions over and over.
A doctor sitting at a desk doing work on a computer with her back to the viewer

Anxiety

For caregivers, providers, receptionists, teens, & children! Long periods of uncertainty (about procedures, costs, approvals) raise anxiety levels for everyone in the flow.
A father holding an infant at home while speaking on the phone with a worried expression

Delays

No one likes waiting for an appointment, and incomplete portal check-in means delays at the front desk of the pediatrician's office. Delays mean cancelled appointments, unhappy patients, & frustrated receptionists.

Front desk re-entry

Incorrectly filled paperwork means patients need to re-enter information at the office. This surprise task places extra burden on caregivers already managing children, and patients already nervous about seeing a provider.

Trust

Patients want to trust their provider hears them. Being asked for the same information repeatedly sends the message they aren't being heard.

The Research Questions

What does the product team need to know?

Where do users drop off
and why?

The paperwork isn't finished, but why? Where are the failures in the flow?

What makes portal check-in
feel valuable?

What would motivate users to switch to, and persist in, this process in the first place?

What changes reduce cognitive load while preserving trust and privacy?

How do we respect the need for reduced tasks during high pressure moments while making sure to gather essential information and managing security concerns?

Participants & Methods

A reasonable estimation of what could have been done in a 1-week time constraint

Participants

Recruitment: UXTweak panel (caregivers + adults reflecting pediatric visit responsibility)

Surveys

n=107; mix of Likert + open-ended; focused on adoption barriers & moments of friction.

*AI-assisted survey question development*

Sample questions

On a scale of 1 (Strongly disagree) -5 (Strongly Agree), I prefer to check into the pediatrician’s office using the patient portal

What are 3 reasons you might not check in via the patient portal?

Analysis

Descriptive statistics + significance testing when appropriate on Likert scale questions

Thematic analysis on open-ended text responses

*AI used for transcription and thematic grouping. AI's grouping was compared to the researcher's grouping for additional perspective*

Findings*

There is a significant gap between what people say they prefer to do during check-in and what they actually do. This supports the hypothesis that users are encountering friction in the design which causes drop-off.

A bar graph displaying that 45% of patients strongly prefer to use a portal for check-in but only 30% always use the portal. This results in a 15 point usage gap.

Friction

Redundancy is the #1 barrier

The most often mentioned reason for not using the portal was the perception of redundancy.“I would just have to fill this paperwork out again at the office anyway.”

Lack of control increases cognitive load

A high number of respondents (52%) said they “strongly agreed” that their most frequently used portal was difficult to navigate. Prevalent themes in the qualitative data were “cluttered screen,” “don’t know what to do next,” and “won’t let me skip.”

Trust & tone impact engagement

Several themes emerged related to users’ feeling the portals are impersonal and unattractive:“looks so clinical” “feels like I’m doing work” “just straight ugly”

Opportunities

Make progress visible

Step count
Time estimate
Clear "what's next"
Confirm submissions

Reduce redundant entry

Prefilled forms
Saved profiles
Confirm what's on file

Support flexible paths

Skip non-applicable sections
Resume processes later
Caregiver/teen modes

Improve tone & trust

Warm, but professional UI
Plain language privacy
"Why we ask" microcopy

Rapid Prototyping & Flow Concepts

I constructed paper sketches with:
black check mark
Skip options for all sections
black check mark
Steps of the process made visible
black check mark
Chunking of sub-processes
Two pen and paper sketches of check-in screens on a mobile deviceTwo more pen and paper sketches of check-in screens on a mobile device. These have a more pictorial focus.A pen and paper sketch of a check-in screen designed to look like lily pads with a frog as a progress marker.
I also partnered with Claude to generate UML diagrams of potential user flows. This keeps the language consistent across product teams.

I focused on generating flows that highlighted differing user realities (caregiver vs teen) and error recovery pathways.
A UML diagram showing the process of logging in, choosing a caregiver or teen profile, and complete the check-out flow. Highlights ability to skip steps in check-in and return later.
A UML diagram illustrating error recovery processes related to incomplete field entry. Shows system response to user actions.

Minimum Viable Product (MVP)

Based on the findings, I’d prioritize a check‑in flow that makes progress obvious, reduces repeat work, and supports pediatric realities (meaning including caregiver proxy & teen access).

Pre-filled forms & on-file confirmations

Visible progress & clear submission confirmations

Flexible navigation

Plain language micro-copy

Reflections

Suprises:

I'd expected to see an overall trend of portal use dropoff after unsuccessful check-in attempts, but the data showed caregivers continued to attempt to use the portal while teens were quicker to abandon it.  

Despite receiving reminders days ahead of upcoming appointments, 68% of users said they attempted check-in within an hour of their appointment.

Validation Plan (If This Were Real):


To move from concept to confidence, I’d validate in two parallel tracks:

1. Mobile usability testing with caregivers and teens (task-based, prototype-driven). The focus is on where people hesitate, re-read, or abandon the flow.

2. Front desk and clinic ops walkthrough to follow what actually lands at the desk after portal submission, and where the handoff breaks down. Data re-entry at the front desk is a failure in the flow, not a user error.

The next sprint would be built around these drop‑offs, confusion points, and trust concerns.


What I'd Change About This Research:

With real product access, I’d pair this work with in‑clinic observation/interviews and portal analytics. The gap between what caregivers say they do, and what they can accomplish with a restless kid next to them is real and measurable. These methods also allow the research team to validate the highest‑risk assumptions and ensure recommendations align with clinical operations and privacy requirements.
A whimsical image of a hand holding a stethoscope up to a teddy bear dressed up as a patient.