Sociodemographic Differences and Factors Affecting Patient Portal Utilization

Martina A Clarke; Elizabeth R Lyden; Jihyun Ma; Keyonna M King; Mohammad Mo Siahpush; Tzeyu Michaud; Regina E Idoate; Athena K Ramos

doi:10.1007/s40615-020-00846-z

Sociodemographic Differences and Factors Affecting Patient Portal Utilization

J Racial Ethn Health Disparities. 2021 Aug;8(4):879-891. doi: 10.1007/s40615-020-00846-z. Epub 2020 Aug 24.

Authors

Martina A Clarke¹, Elizabeth R Lyden², Jihyun Ma², Keyonna M King³, Mohammad Mo Siahpush⁴, Tzeyu Michaud³, Regina E Idoate⁵, Athena K Ramos³

Affiliations

¹ College of Information Science and Technology, School of Interdisciplinary Informatics, University of Nebraska Omaha, Omaha, NE, 68182, USA. martinaclarke@unomaha.edu.
² College of Public Health, Department of Biostatistics, Center for Collaboration on Research, Design and Analysis, University of Nebraska Medical Center, Omaha, NE, 68198-4375, USA.
³ College of Public Health, Department of Health Promotion, Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
⁴ College of Public Health, Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, NE, 68198-4365, USA.
⁵ College of Public Health, Department of Health Promotion, Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE, 68198-4365, USA.

PMID: 32839896
DOI: 10.1007/s40615-020-00846-z

Abstract

Background: The primary function of the patient portal is to give patients greater access to their personal health information. Granting patients electronic access allows them to make well-informed health care decisions.

Objective: This study aimed to identify sociodemographic differences in patient portal use and examine factors affecting patient portal utilization following the final stage of the Meaningful Use program which aimed to promote the use of certified electronic health record (EHR) technology.

Research design: Survey data from Health Information National Trends Survey (HINTS) 5, cycles 1, 2, and 3 were analyzed. The sample included 8291 completed surveys. Multivariable logistic regression on a selected response for each surveyed question was used to assess the racial and ethnic difference after controlling for age, sex, income, and education.

Subjects: Subjects included English and Spanish speaking adults in the USA.

Measures: Measures included assessment of patient portal use, patient portal access, understanding health information, usefulness of health records, and privacy and security.

Results: After adjusting for age, sex, income, and education, there was a significant association between race/ethnicity and patient portal non-users responding, "no need to use online medical record" as the reason for not using the patient portal (P = 0.005). Among the portal users, there were significant associations between race/ethnicity and health care provider maintaining an EHR (P = 0.006), being offered access to their portal (P < 0.001), understanding health information in the portal (P = 0.004), finding the portal useful for health monitoring (P < 0.001), reporting concern about unauthorized access (P = 0.017), and keeping information from health care providers (P = 0.012).

Conclusions: Race/ethnicity affects perceptions on the need for the patient portal, being offered access to a portal, and the reasons to access information online. Understanding the factors affecting patient portal use can inform future strategies aimed at increasing adoption.

Keywords: Patient portals; Patients; Personal health record; Sociodemographic differences; Utilization.

MeSH terms

Adult
Female
Humans
Male
Middle Aged
Patient Portals / statistics & numerical data*
Sociodemographic Factors
Socioeconomic Factors
Surveys and Questionnaires