Patients’ Continuing Use of an Online Health Record: A Quantitative Evaluation of 14,000 Patient Years of Access Data

Abstract

BackgroundOnline access to all or part of their health records is widely demanded by patients and, where provided in form of patient portals, has been substantially used by at least subgroups of patients, particularly those with chronic disease. However, little is reported regarding the longer-term patient use of patient-accessible electronic health record services, which is important in allocating resources. Renal PatientView (RPV) is an established system that gives patients with chronic kidney disease access to live test results and information about their condition and treatment. It is available in most UK renal units with up to 75% of particular patient groups registered in some centers. We have analyzed patient use out to 4 years and investigated factors associated with more persistent use.ObjectiveOur aim was to investigate RPV use by patients over time from initial registration in order to understand which patients choose to access RPV and the endurance of its appeal for different patient groups.MethodsWe analyzed an anonymized extract of the database underlying RPV containing information on patient registration and events including patient access and the arrival of new blood test results or letters that patients might wish to view.ResultsAt the time of the extract, there were 11,352 patients registered on RPV for 0-42 months (median 17). More than half of registrants became persistent users, logging in a median of 2.0 times each month over post-registration intervals of up to 42 months (median 18.9). Provision of assistance with first logon was strongly associated with becoming a persistent user, even at 3 years. Logons by persistent users occurred around the time of consultations/tests, strongly suggestive of patient engagement. While indices indicative of greater deprivation were the strongest determinants of non-participation, they had negligible influence on drop-out rates among established users.ConclusionsIn this mature patient portal system, a large proportion of patients made regular use of their online health records over protracted periods. The patterns and timing of use indicate strong patient interest in detailed information such as recent test results and clinic letters. Supporting patients through the first steps of establishing access to their online records is associated with much higher rates of long-term use of RPV and likely would increase use of other electronic health records provided for patients with chronic disease.

Patterns of Electronic Portal Use among Vulnerable Patients in a Nationwide Practice-based Research Network: From the OCHIN Practice-based Research Network (PBRN)

“…“Superusers” were defined as logging into MyChart a minimum of 24 times (an average of 2 times/month) over a 12-month period. 17 …”

Increasing Patient Portal Activation in a Pediatric Subspecialty Clinic

“…1 Although this study focused on MyChart activation, that does not necessarily translate to usage. 7,8 We have an additional QI study underway to understand how improved MyChart activation affected call volume and family-provider communication.…”

Understanding the Value of Patientview for Enabling Self‐Care Practice in Chronic Kidney Disease

“…Evidence of improved health outcomes following the use of Pa-tientView is limited, partly due to it only having been widely implemented since 2008. Studies tend to focus on usage measures such as uptake, sustained use, or self-reported outcomes such as patients reporting that PatientView helped them to look after themselves better and that they valued the information it gave them (Bartlett et al 2012;Phelps et al 2014;Woywodt et al 2014). There is therefore little evidence to support the rationale that self-care is facilitated by the implementation and use of a patient portal.…”