Even with the extolled benefits of patient portals, there has been some challenges to ensuring patient portal use. This study examines if a patient’s level of information technology (IT) sophistication, defined as the degree of use of diverse information technologies by an individual, is associated with their use of a patient portal. Patients previous experience and exposure to other similar technologies like desktop computer, laptop, internet, smart phone, or social media explains their willingness to use information technology for their health. Data on a cross-sectional survey of 565 individuals in Eastern NC was available for analysis. Multinomial regression analyses revealed that IT sophistication is important in determining whether patients will use a patient portal. It specifies that patients with low IT sophistication compared to those with high IT sophistication were more likely to have never activated their patient portals (RRR = 2.2155, p < 0.009), or to have activated but never used a patient portal (RRR = 3.5869, p < 0.010). The findings of this study should aid healthcare leaders as they strive to improve patient engagement. They should continue to promote the benefits of the patient portal and consider offering personalized support programs for patients with low IT sophistication.
Introduction: Office-based healthcare delivery with limited hours of operation can be a deterrent to seeking medical care for many individuals. Innovative approaches to healthcare delivery, particularly health assessment and screenings, could improve patient engagement and ultimately yield better long-term public health outcomes. Hypothesis: Compared to national averages, elevated rates of undiagnosed and uncontrolled disease will be found among participants living in a rural area with known high endemic disease through worksite-based health assessments. Methods: Between December 2020 and October 2021, we partnered with 13 business for on-the-jobsite health screening clinics. Participants completed a series of questionnaires and a physical assessment. Disease screenings included diabetes, hypertension, kidney disease, cholesterol, sleep apnea, and stroke risk. Results were available immediately following the screening. Physicians conducted one-on-one consultations with participants to discuss their results and advise them, as needed, on treatment and management of their condition. Results: A total of 463 individuals (44.7% white) (54.4% male) were screened. On-site lab results identified 41 (9.0%) participants with an indicator of diabetes (HbA1c ≥6.5) that were previously undiagnosed*. An additional 44 (9.6%) participants had been previously diagnosed with diabetes, but testing results indicated their diabetes was not well controlled (HbA1c ≥6.5). Undiagnosed hypertension (SBP ≥140) was found in 114 (24.7%) participants and 93 (20.2%) participants had diagnosed but uncontrolled hypertension. We also identified 33 (15.9%) participants with indicators of chronic kidney disease (urine protein ≥1), 13 (3.9%) participants with high cholesterol (total cholesterol ≥240), 122 (26.3%) participants with moderate increased risk of heart attack or stroke (CHA 2 DS 2 -VASc ≥2), and 27 (22.0%) with moderate to severe risk of obstructive sleep apnea (STOP-BANG ≥4). Conclusion: Of over 450 individuals screened, nearly a quarter of participants revealed a moderate increased risk of heart attack or stroke. Nearly half of participants had uncontrolled or undiagnosed hypertension and twenty percent of participants suffered from uncontrolled or undiagnosed diabetes. Our mobile, on-the-jobsite health screening clinics provide patients with convenient, walk-in service, immediate results, and physician consultation as a bridge to accessing ongoing care. This screening strategy addresses issues of complexity, cost, and privacy and captures individuals who may otherwise underutilize or avoid engagement with the healthcare system. Longer-term follow-up is planned to determine the public health impact of these on-the-jobsite health screenings. *Percentage based off number screened per condition
Background Patient portals can facilitate the delivery of health care services and support self-management for patients with multiple chronic conditions. Despite their benefits, the evidence of patient portal use among patients with multimorbidity in rural communities is limited. Objective This study aimed to explore the factors associated with portal messaging use by rural patients. Methods We assessed patient portal use among patients with ≥1 chronic diagnoses who sent or received messages via the Epic MyChart (Epic Systems Corporation) portal between January 1, 2015, and November 9, 2021. Patient portal use was defined as sending or receiving a message through the portal during the study period. We fit a zero-inflated negative binomial model to predict portal use based on the patient’s number of chronic conditions, sex, race, age, marital status, and insurance type. County-level characteristics, based on the patient’s home address, were also included in the model to assess the influence of community factors on portal use. County-level factors included educational attainment, smartphone ownership, median income, and primary care provider density. Results A total of 65,178 patients (n=38,587, 59.2% female and n=21,454, 32.92% Black) were included in the final data set, of which 38,380 (58.88%) sent at least 1 message via the portal during the 7-year study period. As the number of chronic diagnoses increased, so did portal messaging use; however, this relationship was driven primarily by younger patients. Patients with 2 chronic conditions were 1.57 times more likely to send messages via the portal than those with 1 chronic condition (P<.001). In comparison, patients with ≥7 chronic conditions were approximately 11 times more likely to send messages than patients with 1 chronic condition (P<.001). A robustness check confirmed the interaction effect of age and the number of diagnoses on portal messaging. In the model including only patients aged <65 years, there was a significant effect of increased portal messaging corresponding to the number of chronic conditions (P<.001). Conversely, this relationship was not significant for the model consisting of older patients. Other significant factors associated with increased portal use include being female; White; married; having private insurance; and living in an area with a higher average level of educational attainment, greater medical provider density, and a lower median income. Conclusions Patients’ use of the portal to send messages to providers was incrementally related to their number of diagnoses. As the number of chronic diagnoses increased, so did portal messaging use. Patients of all ages, particularly those living in rural areas, could benefit from the convenience and cost-effectiveness of portal communication. Health care systems and providers are encouraged to increase the use of patient portals by implementing educational interventions to promote the advantages of portal communication, particularly among patients with multimorbidity.
BACKGROUND Patient portals can facilitate the delivery of health care services and support self-management for patients with multiple chronic conditions. Despite their benefits, the evidence of patient portal use among patients with multimorbidity in rural communities is limited. OBJECTIVE This study aimed to explore the factors associated with portal messaging use by rural patients. METHODS We assessed patient portal use among patients with ≥1 chronic diagnoses who sent or received messages via the Epic MyChart (Epic Systems Corporation) portal between January 1, 2015, and November 9, 2021. Patient portal use was defined as sending or receiving a message through the portal during the study period. We fit a zero-inflated negative binomial model to predict portal use based on the patient’s number of chronic conditions, sex, race, age, marital status, and insurance type. County-level characteristics, based on the patient’s home address, were also included in the model to assess the influence of community factors on portal use. County-level factors included educational attainment, smartphone ownership, median income, and primary care provider density. RESULTS A total of 65,178 patients (n=38,587, 59.2% female and n=21,454, 32.92% Black) were included in the final data set, of which 38,380 (58.88%) sent at least 1 message via the portal during the 7-year study period. As the number of chronic diagnoses increased, so did portal messaging use; however, this relationship was driven primarily by younger patients. Patients with 2 chronic conditions were 1.57 times more likely to send messages via the portal than those with 1 chronic condition (<i>P</i><.001). In comparison, patients with ≥7 chronic conditions were approximately 11 times more likely to send messages than patients with 1 chronic condition (<i>P</i><.001). A robustness check confirmed the interaction effect of age and the number of diagnoses on portal messaging. In the model including only patients aged <65 years, there was a significant effect of increased portal messaging corresponding to the number of chronic conditions (<i>P</i><.001). Conversely, this relationship was not significant for the model consisting of older patients. Other significant factors associated with increased portal use include being female; White; married; having private insurance; and living in an area with a higher average level of educational attainment, greater medical provider density, and a lower median income. CONCLUSIONS Patients’ use of the portal to send messages to providers was incrementally related to their number of diagnoses. As the number of chronic diagnoses increased, so did portal messaging use. Patients of all ages, particularly those living in rural areas, could benefit from the convenience and cost-effectiveness of portal communication. Health care systems and providers are encouraged to increase the use of patient portals by implementing educational interventions to promote the advantages of portal communication, particularly among patients with multimorbidity.
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