Abstract
Background: With emphasis on the meaningful use of electronic health records, patient portals are likely to become increasingly important. Little is known about patient enrollment in, and use of, patient portals after explicit invitation from providers. Objectives: To examine enrollment in, and use of, an electronic patient portal by race/ethnicity, gender and age. Design: Observational, cross sectional study. Participants: Patients with attending physicians seen at one urban, academic primary care practice between May 2008 and October 2009 who received electronic orders inviting their participation in an electronic patient portal. Main Measures: (a) Enrollment in the patient portal, (b) Solicitation of provider advice among enrollees, (c) Requests for medication refills among enrollees. Key Results: Overall, 69% of 7,088 patients enrolled in the patient portal. All minority patients were significantly less likely to enroll than whites: 55% blacks, 64% Latinos and 66% Asians compared with 74% whites (chi-square p<0.05 for all pairwise comparisons). These disparities persisted in adjusted analyses, although differences for Asians were no longer significant. In addition, the oldest patients were less likely to enroll than the youngest (adjusted OR 0.79, 95% CI 0.65-0.97). Although there were no racial/ethnic disparities in use of the patient portal among enrollees, we found differences by age and gender. The youngest patients were significantly less likely to solicit provider advice or request medication refills than any other age group in unadjusted and adjusted analyses. Similarly, male patients were less likely to solicit provider advice than women in all analyses. Conclusion: Large racial/ethnic disparities were seen in enrollment in our patient portal. Among enrollees, use of the portal was similar by race/ethnicity, but not by age or gender. Future efforts to expand use of the patient portal need to address potential mechanisms for these disparities to ensure this technology is accessible to diverse patient populations.
Original language | English (US) |
---|---|
Pages (from-to) | 1112-1116 |
Number of pages | 5 |
Journal | Journal of general internal medicine |
Volume | 26 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2011 |
Funding
This study was conducted at the Northwestern Medical Faculty Foundation, the group practice for faculty of the Feinberg School of Medicine of Northwestern University, which uses a commercial EHR (EpicCare, version Spring 2007, Epic Systems Corporation). Access to the portal is offered to patients at the discretion of their providers. Providers typically discuss the patient portal with their patients and enter an electronic order for interested patients. Patients then receive instructions for enrolling in the portal, which they need to complete at home. Once they enroll, patients are able to perform multiple functions, including administrative tasks (i.e., scheduling appointments) and clinical exchanges (i.e., viewing test results, soliciting provider advice, or requesting medication refills).
Keywords
- Electronic Health Record
- disparities
- patient portal
- race/ethnicity
ASJC Scopus subject areas
- Internal Medicine