Patient Portals: Useful for Whom and for What? A Cross-Sectional Analysis of National Survey Data

Abstract

Background Patients who use patient portals may be more engaged and empowered in their care; however, differences in who accesses patient portals remain. The characteristics of who uses patient portals more frequently and who perceives them as useful may also differ, as well as which functions people use. Objective We assessed the characteristics of patient portal users to examine who uses them more frequently and who perceives them as useful. In addition, we wanted to see if those who use them more frequently or perceive them to be more useful use different functions or more functions of patient portals. Methods Pooled cross-sectional data from 2017 to 2018 Health Information National Trends Survey (HINTS) were used. Ordinal regression models were developed to assess frequency of use and perceived usefulness by demographics, and multivariable logistic regression models were used to examine the association between the use of 10 patient portal functions and frequency of use and perceived usefulness of patient portals. Results The odds of using patient portals more frequently were higher among those with Bachelor's degrees, incomes between $35,000 and $75,000, and those with two or more chronic conditions. Respondents with three or more chronic conditions had higher odds of rating patient portals as useful. Those who used their patient portal 10 or more times in the past year had higher odds of using all functions except for viewing test results compared with those who used their patient portal one to two times per year. Those who rated patient portals as “very useful” had higher odds of using seven of the functions compared with those who rated them “not very”/“not at all useful.” Conclusion It is important to continue to assess usefulness, frequency of use, and overall patient portal function use to identify opportunities to increase patient engagement with patient portals.

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

“…Consistent with previous studies, 9,[17][18][19]21,22,[26][27][28]37,38 we found that portal users were more likely to be younger, female, non-Hispanic White, be privately insured, have higher CCI scores and more likely to live in areas with a higher median income and higher educational attainment. A study of the 2017 and 2018 Health Information National Trends Survey (HINTS) showed higher odds of portal use in respondents with a bachelor's degree and incomes in the middle tertile.…”

“…Adjusted odds ratios (aOR) included adjustments for the random effect and fixed effects. We included predictors based on previous studies 9, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and from significant bivariable statistical tests. To simplify the evaluation of results we categorized ACS estimates into quartiles.…”

“…12 Prior studies suggest that patient portal adoption may vary by sociodemographic characteristics. 9,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] For example, users of myPennMedicine, at the University of Pennsylvania Health System, were found to be younger, White, with higher incomes, and were commercially insured. 9 Among adult patients of University of Florida Health, male sex, Hispanic or African American race, not being married, and having public health insurance or self-pay were negatively associated with adopting MyUFHealth.…”

“…13 Prior studies have found that patient portal adoption is highest among patients who are White, 17,20,22,25,27,29 commercially insured, 17 and have higher incomes. 17,24,27,28 Office visits have also been reported to be either higher 14 or lower 25 among patients who are portal adopters, whereas comorbidity scores are often higher. 20,24,29 Additionally, Arcury et al conducted a survey to evaluate factors associated with patient portal utilization in low-income older adults from two rural and one urban clinic in North Carolina.…”

Leveraging Electronic Health Records to Address Breast Cancer Disparities

“…Although more than 90% of providers offer patient portals, only one-third of patients enroll in them [ 6 •]. And the likelihood of enrollment is lower for patients among racial and ethnic minority groups, who are over 65 years old, and who have low income, low health literacy, or chronic illness [ 7 , 8 , 9 •, 10 •, 11 ]. A factor that might contribute to low enrollment is opt-in policies.…”