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Nonwhite, low-income patients less likely to use electronic patient portals

Patients who were nonwhite, low-income and Spanish-speaking were among those significantly less likely to use electronic patient portals, which would allow them to schedule appointments, receive laboratory results and renew prescriptions online, according to data published in the Journal of the American Board of Family Medicine.

“Underserved patient populations experience barriers to accessing and engaging within the complex health care system, and there are significant disparities in access to care and health outcomes across the United States,” Lorraine S. Wallace, PhD, of the department of biomedical education and anatomy, at the Ohio State University, in Columbus, and colleagues wrote. “Widespread use of electronic health records (EHRs) and other technologies now offer new opportunities for patients to become more active participants in their health care. Patient engagement technologies, such as patient portals, have been proposed as one viable solution to overcome health disparities.”

To analyze patient portal use over 2 years among an underserved adult patient population, the researchers created an EHR data set linking information from practices within the OCHIN (originally known as the Oregon Community Health Information Network, but later renamed to “OCHIN” when additional states joined) practice-based research network. All practices share the centrally hosted EpicCare EHR system, including the English-language MyChart patient portal, starting in 2010.

The researchers studied login data from 36,549 OCHIN patients aged 18 years and older, who were offered MyChart access between May 1, 2012 and April 30, 2013. Participating patients hailed from 13 states, including Alaska, California, Indiana, Massachusetts, Minnesota, Montana, North Carolina, Nevada, Ohio, Oregon, Texas, Washington and Wisconsin.

According to the researchers, 29% of patients who were offered an access code to MyChart logged into their account. Patients known as “super users,” those who logged in a minimum of twice each month during the course of a year, accounted for just 6% of the total. Patients who were male, nonwhite, Hispanic, Spanish-speaking and among the lowest income levels were significantly less likely to use MyChart. In addition, patients who were publicly insured were also less likely to use the service. However, once their account was activated, they were more likely to use the system than patients with private insurance.

“These results point to the potential need for developing, testing and implementing systematic strategies to facilitate initial activation and use of personal portals by patients,” Wallace and colleagues wrote. “Clinical practices, in partnership with community organizations and technology companies, could perhaps offer electronic portal activation and demonstration workshops to patients, where they could set up their accounts with active support and instruction.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.