Pediatric patient portal use in one health system

Abstract

Objective The study sought to assess, for children in one large health system, (1) characteristics of active users of the patient portal (≥1 use in prior 12 months), (2) portal use by adolescents, and (3) variations in pediatric patient portal use. Materials and Methods We analyzed data from the electronic health record regarding pediatric portal use during 2017-2018 across a health system (39 871 pediatric patients). Results Altogether, 63.5% of pediatric patients were active portal users. Children (proxies) who were boys, privately insured, white, and spoke English were more likely to be active users. Common uses involved messaging with physicians, medications, allergies, letters, and laboratory results. By 15 years of age, >50% of adolescents used the portal by themselves (without a proxy). Pediatric portal use varied widely across practices. Discussion Pediatric or adolescent portal use is quite high, but large variations exist. Conclusion Use of the portal for pediatric care may reflect varying pediatric patient engagement.

Disparities in Pediatric Patient Portal Activation and Feature Use

“…The patient portal activation rate in our sample was lower than a recent study conducted in another academic healthcare system. 10 This may be partially explained by the fact that our sample had a higher proportion of publicly insured patients, who are less likely to use patient portals. Our findings that portal activation may not lead to subsequent portal utilization are consistent with prior studies.…”

“…Our findings that portal activation may not lead to subsequent portal utilization are consistent with prior studies. 10 , 13 These findings highlight the need to identify reasons for nonuse among patients with portal accounts and design strategies to enhance patient engagement after portal enrollment.…”

“…Pediatric portal activation rates have ranged from 1% to 64%, with recent studies reporting higher rates. 8–10 Although previous studies suggest that portal activation rates vary by age, insurer, income level, and race/ethnicity, 9 , 10 less is known on what patient-level factors are correlated with the use of specific portal features. Since portal use has been associated with improved outcomes, 3 further understanding of portal use metrics is warranted.…”

Online patient portal use by caregivers in pediatric oncology: Are we widening sociodemographic disparities?

“…Those noted as being of minoritized race or non-English speaking had significantly lower rates of portal activation and use. 21 Within a pediatric urology clinic, those who spoke Spanish or designated their race as "other" or Hispanic were less likely to activate a portal. 22 Authors of the pediatric urology study speculate that differences in enrollment might begin with inequities that originate at the check-in desk with who is invited or encouraged to enroll.…”

Attitudes, experiences, and safety behaviours of adolescents and young adults who read visit notes: Opportunities to engage patients early in their care

“…Although there are limited data on the technology-related healthcare preferences of AYA, some studies demonstrate that young adults want to access their health data online [9][10][11] and as they get older, a greater proportion of them is anticipated to use patient portals. 12,13 Safety experts advocate engaging patients with transparent notes, 14,15 but attaining the potential benefits that come with reading notes requires raising awareness and actual note use by patients, ideally starting when they are young. These individuals may also be ideal advocates for shaping how health technology should continue to evolve in a patient-centred way.…”