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

Abstract

Background Underserved patient populations experience barriers to accessing and engaging within the complex health care system. Electronic patient portals have been proposed as a potential new way to improve access and engagement. We studied patient portal use for 12 consecutive months (365 days) among a large, nationally distributed, underserved patient population within the OCHIN (originally created as the Oregon Community Health Information Network and renamed OCHIN as other states joined) practice-based research network (PBRN). Methods We retrospectively assessed adoption and use of Epic’s MyChart patient portal in the first 12 months after MyChart was made available to the OCHIN PBRN. We examined electronic health record data from 36,549 patients aged ≥18 years who were offered a MyChart access code between May 1, 2012, and April 30, 2013, across the OCHIN PBRN in 13 states. Results Overall, 29% of patients offered an access code logged into their MyChart account. Superusers (minimum of 2 logins per month over a 12-month period) accounted for 6% of users overall. Men, nonwhite patients, Hispanic patients, Spanish-speaking patients, and those with the lowest incomes were significantly less likely to activate. Publicly insured and uninsured patients were also less likely to log in to their MyChart account, but once activated they were more likely than privately insured patients to use MyChart functions. Conclusions Our findings suggest that, compared with others, certain patient groups may be less interested in using patient portals or may have experienced significant barriers that prevented use. Making portal access available is a first step. Additional studies need to specifically identify health system–, clinic-, and patient-level barriers and facilitators to portal adoption and use.

Patient portal readiness among postpartum patients in a safety net setting

“…Thus, the portal is not a passive internet display of electronic health data, but a forum to engage with the healthcare provider. These findings are consistent with other studies that show that more than half of patients in a safety net setting expressed interest in emailing providers and thought it would improve efficiency and avoid unnecessary visits [28]. In our study, the patients expressed confidence that messages would be answered, which suggests that policies must be implemented specific to the functions of the portal and the response by the organization, both clinically and administratively [29].…”

How Do Patients with Mental Health Diagnoses Use Online Patient Portals? An Observational Analysis from the Veterans Health Administration

“…This may be explained in part by the high rates of psychological and physiological comorbidities observed in Veterans who have experienced MST (Hyun et al 2009; Waitzkin et al 2018;Yaeger et al 2006), which may lead to greater healthcare use, in general, and unique care needs. Additionally, while both male and female Veterans experience it, MST is more prevalent among women Veterans; women Veterans tend to be younger than their male counterparts, and (while emerging evidence suggests this is mixed) may be more likely to be portal users in general (Goel et al 2011;VA 2017;Wallace et al 2016) and may also prefer to avoid VA hospitals if they are not comfortable there. Veterans who had experienced MST were followed by those with stress and mood-related disorders (depression, anxiety disorders, and PTSD), while those with adjustment disorder, substance use disorder, bipolar disorder and psychotic disorder were the least likely to be registered My HealtheVet users and adopters of the main portal features.…”

Education Research: Electronic patient portal enrollment and no-show rates within a neurology resident clinic

“…These demographic findings are consistent with those previously seen in a variety of practice settings; however, in addition, preferred language, type of insurance, and economic status contributed to portal adoption. 5,7,13,18 Given there is no singular factor contributing to portal adoption, there have been several modalities and suggestions to encourage utilization of this resource. 19,20 It remains uncertain how this translates into an NRC; thus further investigation and validation will be necessary.…”