Portals of Change: How Patient Portals Will Ultimately Work for Safety Net Populations

Abstract

Despite the implementation of internet patient portals into the safety net after the introduction of the Affordable Care Act in the United States, little attention has been paid to the process of engaging vulnerable patients into these portals. The portal is a health technology tool that was developed with a mainstream, English-speaking audience in mind. Thus, there are valid concerns that such technologies will actually exacerbate health care disparities, conferring further advantages to the already advantaged. In this paper, we describe a framework for portal engagement (awareness, registration, and use) among safety net patients. We incorporate the experiences in the Los Angeles County Department of Health Services to illustrate important contextual factors for portal outreach in our safety net. Finally, we discuss considerations for moving forward with health technology in the safety net as the next version of patient portals are being developed.

Clinician Experience with Telemedicine at a Safety-net Hospital Network during COVID-19: A Cross-sectional Survey

“…22,47 For barriers in digital literacy, robust evidence exists for interventions to support individual-level patient preparation for portal access, which is likely to extend to telemedicine as well. [48][49][50][51][52] For limited English proficiency patients, dissemination of best practices for interpreter services must be standardized. 24 Finally, the design of telemedicine platforms and instructional tools must engage patients and stakeholders from vulnerable populations, applying user-centered design or other participatory methods.…”

Patients Contributing to Visit Notes: Mixed Methods Evaluation of OurNotes

“…Third, it is clear from the patient participation rate that we must learn more about how to encourage patients to take advantage of new opportunities to provide information to their clinicians outside of time-pressured encounters. For many, this involves registering more patients on patient portals, particularly those from vulnerable populations, and ensuring that they have adequate access, education, and support to use the portal [ 20 , 21 ]. Today, many patients fill out forms on paper or tablet computers in the waiting room [ 22 ].…”

Characteristics of Medicare beneficiaries utilizing telemedicine after July 2020

“…Previous research shows that Medicare claim measures of dementia based on International Classification of Disease (ICD) coding lack sensitivity, especially for men, younger adults, and racial/ethnic minorities. [1][2][3][4][5][6] One study found that the validity of the dementia measure based on Medicare claims data increased between 2006 and 2012 and…”