Use of an Electronic Patient Portal Among Disadvantaged Populations

Ancker, Jessica S.; Barrón, Yolanda; Rockoff, Maxine L.; Hauser, Diane; Pichardo, Michelle; Szerencsy, Adam; Calman, Neil S.

doi:10.1007/s11606-011-1749-y

Cited by 319 publications

(274 citation statements)

References 15 publications

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“…Covariates for adjustment were chosen according to clinical significance and possible effect on portal adoption (1,(3)(4)(5)(6)(7)(8)10,11,(13)(14)(15)29,31,33,34,36,(54)(55)(56)(57)(58)(59)(60)(61)(62)(63). Sociodemographic variables were age, sex, race, marital status, insurance status, neighborhood median household income, tobacco use, and follow-up duration.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…We sought to address this gap by examining portal use, including secular trends, in universityaffiliated general nephrology clinics. Given previous literature indicating that underserved groups are less likely to use EHR portals (32)(33)(34)(35)(36), we hypothesized that race, neighborhood median household income, and insurance status would be associated with portal use and of particular concern in view of documented CKD disparities in these groups (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). In addition, we believed that BP control, a key modifiable outcome that affects CKD progression, would depend on patient adherence, self-monitoring, and patient-provider communication.…”

Section: Introductionmentioning

confidence: 99%

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Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Jhamb

Cavanaugh

Bian

et al. 2015

Clinical Journal of the American Society of Nephrology

126

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Background and objectives Electronic health record (EHR) patient portals allow individuals to access their medical information with the intent of patient empowerment. However, little is known about portal use in nephrology patients. We addressed this gap by characterizing adoption of an EHR portal, assessing secular trends, and examining the association of portal adoption and BP control (,140/90 mmHg).Design, setting, participants, & measurements Patients seen between January 1, 2010, and December 31, 2012, at any of four university-affiliated nephrology offices who had at least one additional nephrology follow-up visit before June 30, 2013, were included. Sociodemographic characteristics, comorbidities, clinical measurements, and office visits were abstracted from the EHR. Neighborhood median household income was obtained from the American Community Survey 2012.Results Of 2803 patients, 1098 (39%) accessed the portal. Over 87% of users reviewed laboratory results, 85% reviewed their medical information (e.g., medical history), 85% reviewed or altered appointments, 77% reviewed medications, 65% requested medication refills, and 31% requested medical advice from their renal provider. ConclusionWhile portal adoption appears to be increasing, greater attention is needed to understand why vulnerable populations do not access it. Future research should examine barriers to the use of e-health technologies in underserved patients with CKD, interventions to address them, and their potential to improve outcomes.

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Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Jhamb

Cavanaugh

Bian

et al. 2015

Clinical Journal of the American Society of Nephrology

126

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“…[6][7][8] One study suggested that patient use of an online portal with refill function increased adherence to statin medications for those with diabetes receiving care in an integrated health system. 9,10 Studies also report that low education, income, and Internet access are associated with lower online use of an SMR, though socioeconomic status (SES) alone does not account for lower SMR use by racial-ethnic minorities. 11 African Americans and Latinos are less likely to use an online SMR system that has options to request medication refills.…”

Section: Introductionmentioning

confidence: 99%

Disparities in the Use of Internet and Telephone Medication Refills among Linguistically Diverse Patients

et al. 2015

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BACKGROUND: Health systems are increasingly implementing remote telephone and Internet refill systems to enhance patient access to medication refills. Remote refill systems may provide an effective approach for improving medication non-adherence, but more research is needed among patients with limited English proficiency with poor access to remote refill systems. OBJECTIVE: To compare the use of remote medication refill systems among limited-English-proficiency (LEP) and English-proficient (EP) patients with chronic conditions. METHODS: Cross-sectional survey in six languages/ dialects (English, Cantonese, Mandarin, Korean, Vietnamese, and Spanish) of 509 adults with diabetes, hypertension, or hyperlipidemia. Primary study outcomes were self-reported use of 1) Internet refills, 2) telephone refills, and 3) any remote refill system. LEP was measured by patient self-identification of a primary language other than English and a claims record of use of an interpreter. Other measures were age, gender, education, years in the U.S., insurance, health status, chronic conditions, and number of prescribed medications. Analyses included multivariable logistic regression weighted for survey non-response. RESULTS: Overall, 33.1 % of patients refilled their medications by telephone and 31.6 % by Internet. Among LEP patients (n=328), 31.5 % refilled by telephone and 21.2 % by Internet, compared with 36.7 % by telephone and 52.7 % by Internet among EP patients (n=181). Internet refill by language groups were as follows: English (52.7 %), Cantonese (34.9 %), Mandarin (17.4 %), Korean (16.7 %), Vietnamese (24.4 %), and Spanish (12.6 %). Compared to EP patients, LEP patients had lower use of any remote refill system (adjusted odds ratio [AOR] 0.18; p<0.001), CONCLUSIONS: LEP patients are significantly less likely than EP patients to use any remote medication refill system. Increased reliance on current systems for remote medication refills may increase disparities in health outcomes affecting LEP patients with poor access to telephone and Internet medication refills.

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“…4 In this issue of JGIM, two studies contribute to the growing evidence base around disparities in the use of health information technology. 5,6 Goel et al studied a single group practice affiliated with an academic medical center, and analyzed use of a patient portal that is directly integrated within a commercial electronic health record. In this setting, providers offer enrollment to their patients, and these offers were tracked via the placement of electronic orders.…”

mentioning

confidence: 99%

“…These investigators found racial disparities across the entire spectrum of engaging patients in effective use of the portal, with lower rates of offering enrollment among blacks compared to whites, as well as lower rates of subsequent registration and usage of the patient portal. 6 These studies raise several important issues as we consider the role of health information technology in addressing racial disparities in quality of care. It is vital to develop an evidence base regarding the impact of differential access to health information technology on quality of care and outcomes for minority patients.…”

mentioning

confidence: 99%

Health Information Technology and Disparities in Quality of Care

Sequist

2011

J GEN INTERN MED

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Use of an Electronic Patient Portal Among Disadvantaged Populations

Cited by 319 publications

References 15 publications

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

Disparities in the Use of Internet and Telephone Medication Refills among Linguistically Diverse Patients

Health Information Technology and Disparities in Quality of Care

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