Characteristics of Adult Primary Care Patients Who Use the Patient Portal: A Cross-Sectional Analysis

Casacchia, Nicholas J; Rosenthal, Gary E.; O’Connell, Nathaniel S.; Bundy, Richa; Witek, Lauren; Wells, Brian J.; Palakshappa, Deepak

doi:10.1055/a-1951-3153

Cited by 8 publications

(6 citation statements)

References 40 publications

(83 reference statements)

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“…To the best of our knowledge, this is one of the first studies to focus on portal usage for individuals 0–18 years receiving care in safety-net settings, filling a crucial gap in the literature and contributing to our understanding of drivers of portal usage in this unique population. Our findings are consistent with other studies across pediatric 23 and adult 51 , 52 primary care settings, suggesting that factors contributing to portal use in both populations are similar.…”

Section: Discussionsupporting

confidence: 91%

Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study

Dang,

Chavez,

Pham

et al. 2024

DIGITAL HEALTH

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Objective This study examined the proxy use of patient portals for children in a large Federally Qualified Health Centers (FQHC) network in Texas. Methods We used de-identified individual-level data of patients, 0–18 years, who had 1+ visits between December 2018 and November 2020. Logistic regression was used to examine patient-, clinic-, and geographic-level factors associated with portal usage by an assumed proxy (i.e. parent or guardian). Results The proxy portal usage rate increased from 28% in the pre-pandemic months (November 2018–February 2020) to 34% in the pandemic months (March–Nov 2020). Compared to patients 0–5 years, patients aged 6 to 18 years had lower odds of portal usage (6–10 OR: 0.77, p < 0.001; 11–14 OR: 0.62, p < 0.001; 15–18 OR: 0.51, p < 0.001). Minoritized groups had significantly lower odds of portal usage when compared to their non-Hispanic White counterparts (non-Hispanic Black OR: 0.78, p < 0.001; Hispanic OR 0.63, p < 0.001; Asian OR: 0.69, p < 0.001). Having one chronic condition was associated with portal usage (OR: 1.57, p < 0.001); however, there were no significant differences in portal usage between those with none or multiple chronic conditions. Portal usage also varied by service lines, with obstetrics and gynecology (OR: 1.84, p < 0.001) and behavioral health (OR 1.82, p < 0.001) having the highest odds of usage when compared to pediatrics. Having a telemedicine visit was the strongest predictor of portal usage (OR: 2.30, p < 0.001), while residence in zip codes with poor broadband internet access was associated with lower odds of portal usage (OR: 0.97, p < 0.001). Conclusion While others have reported portal usage rates as high as 64% in pediatric settings, our analysis suggests proxy portal usage rates of 30% in pediatric FQHC settings, with race/ethnicity, age group, and chronic disease status being significant drivers of portal non-usage. These findings highlight the need for appropriate and responsive health information technology approaches for vulnerable populations receiving care in low-resource settings.

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Section: Discussionsupporting

confidence: 91%

Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study

Dang,

Chavez,

Pham

et al. 2024

DIGITAL HEALTH

View full text Add to dashboard Cite

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“…[99][100][101][102][103][104][105][106] Investing in the continued improvement of portals has the potential for benefits to patient care and beyond. However, it also means that addressing the well-established disparities in uptake and use 56,58,69,[71][72][73][107][108][109][110][111] is critical for equitable access to these benefits. HCOs should develop, evaluate, and disseminate the results of innovative portal efforts to equitably engage patients; suggestions from the literature include screening Box 1 Recommendations for health care organizations, electronic health record vendors, and researchers to continue improving the design and implementation of patient portals based on the findings from this state-of-the-art review…”

Section: Discussionmentioning

confidence: 99%

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

Reynolds,

Cobb,

Steitz

et al. 2023

Appl Clin Inform

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Background and Objective Recent external factors—the 21st Century Cures Act and the coronavirus disease 2019 (COVID-19) pandemic—have stimulated major changes in the patient portal landscape. The objective of this state-of-the-art review is to describe recent developments in the patient portal literature and to identify recommendations and future directions for the design, implementation, and evaluation of portals. Methods To focus this review on salient contemporary issues, we elected to center it on four topics: (1) 21st Century Cures Act's impact on patient portals (e.g., Open Notes); (2) COVID-19's pandemic impact on portals; (3) proxy access to portals; and (4) disparities in portal adoption and use. We conducted targeted PubMed searches to identify recent empirical studies addressing these topics, used a two-part screening process to determine relevance, and conducted thematic analyses. Results Our search identified 174 unique papers, 74 were relevant empirical studies and included in this review. Among these papers, we identified 10 themes within our four a priori topics, including preparing for and understanding the consequences of increased patient access to their electronic health information (Cures Act); developing, deploying, and evaluating new virtual care processes (COVID-19); understanding current barriers to formal proxy use (proxy access); and addressing disparities in portal adoption and use (disparities). Conclusion Our results suggest that the recent trends toward understanding the implications of immediate access to most test results, exploring ways to close gaps in portal adoption and use among different sub-populations, and finding ways to leverage portals to improve health and health care are the next steps in the maturation of patient portals and are key areas that require more research. It is important that health care organizations share their innovative portal efforts, so that successful measures can be tested in other contexts, and progress can continue.

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“…28 Patient portal adoption rates also vary by patient demographics and socioeconomic factors with patients who are female, white, and commercially insured having higher odds of using their patient portal. 29 Within our own community, 77% of eligible patients had an active patient portal reflective of high usage in our patient population. However, there were large discrepancies between faculty and resident clinics (86.4% active and 36.8% active, respectively).…”

Section: Discussionmentioning

confidence: 99%

The Future of Community Outreach: Using Patient Portals to Provide Voter Resources during the Coronavirus Disease 2019 Pandemic

et al. 2023

Self Cite

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Background During the coronavirus disease 2019 (COVID-19) pandemic, there was a concern for the 2020 general election becoming a superspreader event due to in-person voting. Objectives Our project addressed this concern by disseminating nonpartisan websites detailing safe voter options in the state of North Carolina to prevent community spread of the virus as much as possible. Methods In this study, patient portals were used to disseminate a Research Electronic Data Capture survey containing embedded links to voter resources including nonpartisan websites discussing voting options. The survey also asked for demographic data and sentiments regarding the resources provided. Quick response (QR) codes with the survey link were also placed in the clinics during the study period. Results The survey was sent to 14,842 patients who had at least one patient encounter in the past 12 months at one of three General Internal Medicine clinics at Atrium Health Wake Forest Baptist. Survey participation through both the patient portals and QR codes was assessed. Patient sentiments toward the voter resources in regard to (1) interest and (2) perceived helpfulness were collected in the survey. In total, 738 (4.99%) patients filled out the survey. Eighty-seven percent of survey respondents reported that the voter resources were helpful. Significantly more black patients than white (29.3 vs. 18.2, p < 0.05) voiced interest in voter resources. There was no statistical significance across gender or reported comorbidities. Conclusion Multicultural, underserved, and underinsured patients perceived the most benefit. During public health crises, patient portal messages can be used to bridge information gaps and promote better health outcomes in a timely and effective manner.

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Characteristics of Adult Primary Care Patients Who Use the Patient Portal: A Cross-Sectional Analysis

Cited by 8 publications

References 40 publications

Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study

Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study

The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating

The Future of Community Outreach: Using Patient Portals to Provide Voter Resources during the Coronavirus Disease 2019 Pandemic

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