Difference between revisions of "Disparities in Patient Portal Use"

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Studies suggest that use of patient portals can increase medication accuracy and safety(3), improve quality outcomes(4), and increase patient and care partner activation in the acute care(5) and outpatient settings(6). However, though 92% percentage of healthcare organizations reported offering portals in 2015(1), this technology has not been used by a majority of patients.(7,8) Hong et al. analyzed data from the Health Information National Trends Survey (HINTS) and reported use rates of 25.6% in 2014,30.5% in 2017, and 31.4% in 2018.(8)
 
Studies suggest that use of patient portals can increase medication accuracy and safety(3), improve quality outcomes(4), and increase patient and care partner activation in the acute care(5) and outpatient settings(6). However, though 92% percentage of healthcare organizations reported offering portals in 2015(1), this technology has not been used by a majority of patients.(7,8) Hong et al. analyzed data from the Health Information National Trends Survey (HINTS) and reported use rates of 25.6% in 2014,30.5% in 2017, and 31.4% in 2018.(8)
  
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Furthermore, multiple studies have found that patient subgroups, who are also more likely to have adverse health  outcomes, are significantly less likely to use patient portals (1,2). Lyles et al. wrote in a commentary in the American Journal of Public Health in 2017, "From a clinical appropriateness and effectiveness perspective, arguably the mose vulnerable populations have the most to gain from meaningfully interacting with their medical record data, through potential improvements in convenience, communication, and self-management."
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Furthermore, multiple studies have found that some patient subgroups are significantly less likely to use patient portals (1,2). These groups are also more likely to have adverse health outcomes and potentially stand to benefit from increased access to health information and engagement in health care. As Lyles et al. wrote in a commentary in the American Journal of Public Health in 2017, "From a clinical appropriateness and effectiveness perspective, arguably the most vulnerable populations have the most to gain from meaningfully interacting with their medical record data, through potential improvements in convenience, communication, and self-management."
  
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== Evidence of Disparities ==
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As reported by Grossman et al.in 2019 in the Journal of the American Medical Informatics Association (JAMIA), "More than 100 studies document disparities in patient portal  use among vulnerable populations."
  
 
== Potential Interventions to Increase Use and Decrease Disparities ==
 
== Potential Interventions to Increase Use and Decrease Disparities ==

Revision as of 03:55, 28 October 2020

Patient portals are an increasingly prevalent way for patients to access their own health records and engage in their own care. However, studies indicate that certain patient subgroups are significantly less likely to use patient portals (1,2).

Significance

Studies suggest that use of patient portals can increase medication accuracy and safety(3), improve quality outcomes(4), and increase patient and care partner activation in the acute care(5) and outpatient settings(6). However, though 92% percentage of healthcare organizations reported offering portals in 2015(1), this technology has not been used by a majority of patients.(7,8) Hong et al. analyzed data from the Health Information National Trends Survey (HINTS) and reported use rates of 25.6% in 2014,30.5% in 2017, and 31.4% in 2018.(8)

Furthermore, multiple studies have found that some patient subgroups are significantly less likely to use patient portals (1,2). These groups are also more likely to have adverse health outcomes and potentially stand to benefit from increased access to health information and engagement in health care. As Lyles et al. wrote in a commentary in the American Journal of Public Health in 2017, "From a clinical appropriateness and effectiveness perspective, arguably the most vulnerable populations have the most to gain from meaningfully interacting with their medical record data, through potential improvements in convenience, communication, and self-management."

Evidence of Disparities

As reported by Grossman et al.in 2019 in the Journal of the American Medical Informatics Association (JAMIA), "More than 100 studies document disparities in patient portal use among vulnerable populations."

Potential Interventions to Increase Use and Decrease Disparities

(page under construction)

References

1 Grossman LV, Masterson Creber RM, Benda NC, Wright D, Vawdrey DK, Ancker JS. Interventions to increase patient portal use in vulnerable populations: a systematic review. J Am Med Inform Assoc. 2019 Aug 1;26(8-9):855-870. doi: 10.1093/jamia/ocz023. PMID: 30958532; PMCID: PMC6696508.

2 Lyles CR, Fruchterman J, Youdelman M, Schillinger D. Legal, Practical, and Ethical Considerations for Making Online Patient Portals Accessible for All. Am J Public Health. 2017 Oct;107(10):1608-1611. doi: 10.2105/AJPH.2017.303933. Epub 2017 Aug 17. PMID: 28817324; PMCID: PMC5607665.

3 Heyworth L, Paquin AM, Clark J, Kamenker V, Stewart M, Martin T, Simon SR. Engaging patients in medication reconciliation via a patient portal following hospital discharge. J Am Med Inform Assoc. 2014 Feb;21(e1):e157-62. doi: 10.1136/amiajnl-2013-001995. Epub 2013 Sep 13. PMID: 24036155; PMCID: PMC3957401.

4 Kruse CS, Bolton K, Freriks G. The effect of patient portals on quality outcomes and its implications to meaningful use: a systematic review. J Med Internet Res. 2015 Feb 10;17(2):e44. doi: 10.2196/jmir.3171. PMID: 25669240; PMCID: PMC4342639.

5 Schnock KO, Snyder JE, Fuller TE, Duckworth M, Grant M, Yoon C, Lipsitz S, Dalal AK, Bates DW, Dykes PC. Acute Care Patient Portal Intervention: Portal Use and Patient Activation. J Med Internet Res. 2019 Jul 18;21(7):e13336. doi: 10.2196/13336. PMID: 31322123; PMCID: PMC6670280.

6 Irizarry T, DeVito Dabbs A, Curran CR. Patient Portals and Patient Engagement: A State of the Science Review. J Med Internet Res. 2015 Jun 23;17(6):e148. doi: 10.2196/jmir.4255. PMID: 26104044; PMCID: PMC4526960.

7 Lin SC, Lyles CR, Sarkar U, Adler-Milstein J. Are Patients Electronically Accessing Their Medical Records? Evidence From National Hospital Data. Health Aff (Millwood). 2019 Nov;38(11):1850-1857. doi: 10.1377/hlthaff.2018.05437. PMID: 31682494.

8 Hong YA, Jiang S, Liu PL. Use of Patient Portals of Electronic Health Records Remains Low From 2014 to 2018: Results From a National Survey and Policy Implications. Am J Health Promot. 2020 Jul;34(6):677-680. doi: 10.1177/0890117119900591. Epub 2020 Feb 7. PMID: 32030989.

8 Turner K, Clary A, Hong YR, Alishahi Tabriz A, Shea CM. Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study. J Med Internet Res. 2020 Sep 17;22(9):e18870. doi: 10.2196/18870. PMID: 32940620; PMCID: PMC7530687.

9 Anthony DL, Campos-Castillo C, Lim PS. Who Isn't Using Patient Portals And Why? Evidence And Implications From A National Sample Of US Adults. Health Aff (Millwood). 2018 Dec;37(12):1948-1954. doi: 10.1377/hlthaff.2018.05117. PMID: 30633673.

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Submitted by Jennifer Lamberg, MD

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