Activation and Utilization of an Electronic Health Record Patient Portal at an Academic Medical Center—Impact of Patient Demographics and Geographic Location

Oest, Sarah E R; Hightower, Maia; Krasowski, Matthew D.

doi:10.1177/2374289518797573

Cited by 41 publications

(52 citation statements)

References 31 publications

(51 reference statements)

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“…The institutional patient portal allows patient access to laboratory test results and radiologic imaging reports [41,42]. Authorized health care providers can manually release diagnostic test results to the patient portal once the results are finalized in the EHR; the results then immediately appear in the patient portal.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously analyzed general patterns of patient access of diagnostic test results through the patient portal (Epic MyChart) used at our institution, a Midwestern academic medical center (University of Iowa Hospitals and Clinics; UIHC) [41,42]. One previous study analyzed broad patterns of diagnostic test release and patient access, in particular, focusing on the mechanism and timing of results transmittal to the patient portal [41].…”

Section: Introductionmentioning

confidence: 99%

“…This previous study provides details on the release categories for diagnostic tests and also describes the challenges and potential safety issues encountered at UIHC with patient access of their own test results/reports. A later study focused in detail on outpatient use of the patient portal and identified disparities in portal activation and usage by underrepresented minorities [42].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

Foster¹,

Krasowski²

2019

J Med Internet Res

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Background Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients. Objective The study aimed to assess patient portal utilization by ED patients at an academic medical center using account activation rates along with the rates of access of diagnostic test results (laboratory results and radiology reports), analyzing the impact of age, gender, and self-reported patient race. Methods This institutional review board–approved retrospective study was performed at a 60,000-visits-per-year university-based ED. We utilized EHR data reporting tools to examine EHR portal activation and utilization for all patients who had at least one ED encounter with one or more diagnostic tests performed between October 1, 2016, and October 1, 2017. The total dataset for laboratory testing included 208,635 laboratory tests on 25,361 unique patients, of which 9482 (37.39%) had active portal accounts. The total dataset for radiologic imaging included 23,504 radiology studies on 14,455 unique patients, of which 5439 (37.63%) had an active portal account. Results Overall, 8.90% (18,573/208,635) of laboratory tests and 8.97% (2019/22,504) of radiology reports ordered in the ED were viewed in the patient portal. The highest rates of viewing of laboratory and radiology results were seen for those who were female, were aged 0 to 11 years (parent or guardian viewing by proxy) and 18 to 60 years, and self-reported their race as Caucasian or Asian. The lowest rates were for those who were teenagers, aged older than 81 years, African American/black, and Hispanic/Latino. Infectious disease, urinalysis, and pregnancy testing constituted the highest number of laboratory tests viewed. Magnetic resonance imaging reports were viewed at higher rates than computed tomography or x-ray studies ( P <.001). Approximately half of all the diagnostic test results accessed by patients were reviewed within 72 hours of availability in the patient portal (laboratory results: 9904/18,573, 53.32% and radiology reports: 971/2019, 48.1%). On the other extreme, 19.9% (3701/18,573) of laboratory results and 31.6% (639/2019) of radiology reports were viewed more than 2 weeks after availability in the portal. Conclusions The data highlight the relatively low use of a patient portal by ED patients and existing disparities between patient groups. There can be wide lag time (months) between result/report availability and access by patients. Opportunities for improvement exist for both activation and more robust utilization of patient portals by ED patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

Foster¹,

Krasowski²

2019

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Age group was broken out into seven categories. We felt it was necessary to look at several groups to be able to tease out generational patient portal utilization (Aljabril et al 2018;Oest, Hightower, & Krasowski, 2018). Age categories were as follows: 20-30 (28), 31-40 (104), 41-50 (193), 51-60 (211), 61-70 (153), 71-80 (31), and 80+ (48).…”

Section: Findings and Data Analysismentioning

confidence: 99%

An exploratory study of patient portal adoption and use in multiple clinical specialty departments

Bronsburg

Durity

Ramim

2019

OJAKM

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A patient portal is an effective vehicle for health information dissemination, a key component of knowledge management. The focus of this exploratory research study was to examine how demographic variables of gender and age as well as clinical specialty grouping affect patient portal adoption and use at a hospital in South Florida. We conducted a semi-structured interview focusing on portal adoption and usage with 768 patients at their scheduled appointments. Results showed that younger participants aged 20 to 30 used the portal significantly less than other age groups in the study. Patients between the ages of 41 and 60 use the portal the most. Findings suggest a need to expand patient portal functionality, portal education and awareness to increase patient portal use. These preliminary findings will support a broader effort investigating patient portal use and barriers such as eHealth literacy skills.

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“…Given that disparities exist in the adoption and use of consumer informatics tools [ 27 , 29 , 30 ], researchers must evaluate ways to reach vulnerable populations when testing new consumer information technologies. Current trends suggest that internet access is no longer the main cause of the digital divide [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Previsit Contextual Data Collection on Patient-Provider Communication and Patient Activation: Study Protocol for a Randomized Controlled Trial

et al. 2020

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Background Patient-centered care is respectful of and responsive to individual patient preferences, needs, and values. To provide patient-centered care, clinicians need to know and incorporate patients’ context into their communication and care with patients. Patient contextual data (PCD) encompass social determinants of health and patients’ needs, values, goals, and preferences relevant to their care. PCD can be challenging to collect as a routine component of the time-limited primary care visit. Objective This study aims to determine if patient-provider communication and patient activation are different for patient users and patient nonusers of an electronic health record (EHR)–integrated PCD tool and assess if the impact of using PCD on patient-provider communication and patient activation differs for Black and White patients. Methods We describe a randomized controlled trial of a prospective cohort of non-Hispanic White and Black patients who receive primary care services at a midwestern academic health care system in the United States. We will evaluate whether providing PCD through a consumer informatics tool enhances patient-provider communication, as measured by the Communication Assessment Tool, and we will evaluate patient activation, as measured by the Patient Activation Measure for PCD tool users and nonusers. Furthermore, owing to racial disparities in care and communication, we seek to determine if the adoption and use of the tool might narrow the differences between patient groups. Results The trial was funded in November 2017 and received local ethics review approval in February 2019. The study began recruitment in April 2019 and enrollment concluded in October 2019 with 301 participants. The analysis was completed in May 2020, and trial results are expected to be published in winter 2020. Conclusions Recently, there has been increased attention to the role of health information technology tools to enable patients to collaborate with providers through the sharing of PCD. The adoption of such tools may overcome the barriers of current EHRs by directly engaging patients to submit their contextual data. Effectively, these tools would support the EHR in providing a more holistic understanding of the patient. Research further supports that individuals who have robust digital engagement using consumer informatics tools have higher participation in treatment follow-up and self-care across populations. Therefore, it is critical to investigate interventions that elicit and share patients’ social risks and care preferences with the health care team as a mechanism to improve individualized care and reduce the gap in health outcomes. Trial Registration ClinicalTrials.gov NCT03766841; https://clinicaltrials.gov/ct2/show/NCT03766841 International Registered Report Identifier (IRRID) RR1-10.2196/20309

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Activation and Utilization of an Electronic Health Record Patient Portal at an Academic Medical Center—Impact of Patient Demographics and Geographic Location

Cited by 41 publications

References 31 publications

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study

An exploratory study of patient portal adoption and use in multiple clinical specialty departments

The Impact of Previsit Contextual Data Collection on Patient-Provider Communication and Patient Activation: Study Protocol for a Randomized Controlled Trial

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