Previously we had been using a telephone based service that patients could access for messages about labs, etc. so out patients were used to our way of leaving messages rather than having someone call for a nice chat. When we went electronic we made it plain that we were doing so more or less under duress. Then my front office person created a two page instruction sheet on how to access the portal. We have an electronic scrolling sign in the waiting room that also sings the praise of the portal and ability to use it for two way messaging. Then we make it pretty clear; the options are use the portal or make an appointment. Like it or not, an e-mail address is now pretty much an assumption, like a phone number, and one is going to be seriously inconvenienced by refusal to get and use one. There has been amazingly little pushback, and a lot of positive reinforcement.
