Disparities in Patient Portal Use

Patient portals are an increasingly prevalent way for patients to access their own health records and engage in their own care. However, research documents 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), in a nationally representative survey in the US in 2017, 63% of insured respondents reported not using a portal in the prior year(7), indicating that . Furthermore, multiple studies show disparities in likelihood as noted by

Evidence of Disparities

As reported by Grossman et al.in 2019, "More than 100 studies document disparities in patient portal use among vulnerable populations."

Interventions to Increase Use and Decrease Disparities

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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 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.

Submitted by Jennifer Lamberg, MD