Health information portals (HIPs) are now an established channel for providing reliable and relevant health information. Recently the concept of smart health information portal was proposed to advance its learning capability and the use of smart technology to sustain its operations and content quality assessment. This research investigates the concept of usage-driven design as an important dimension of smart HIP. Such capability is argued to be important to bridge the gaps between the system design and the users’ needs. This paper describes a design-science research which proposes and illustrates an approach for utilizing insights from usage data to address search issues. A conceptual approach and a modified HIP architecture to enable usage-driven capability are described. This is followed by two specific applications, a HIP-specific content issue reporting tool and a topic search feature, to demonstrate how usage data can enhance usage in HIP while being adapted to fit the context of a health portal. Empirical findings suggest that the adaptation of usage-driven approach for health information portals needs to concentrate more on content management, which is generally overlooked compared to information retrieval functionality. Based on the implementation, the paper identifies design principles to ensure effective operation of the approach.