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Appl Clin Inform 2022; 13(05): 1053-1062
DOI: 10.1055/a-1951-3153
Research Article

Characteristics of Adult Primary Care Patients Who Use the Patient Portal: A Cross-Sectional Analysis

Nicholas J. Casacchia
1   Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
,
Gary E. Rosenthal
2   Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
,
Nathaniel S. O'Connell
3   Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
4   Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
,
Richa Bundy
2   Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
,
Lauren Witek
2   Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
,
Brian J. Wells
1   Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
3   Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
4   Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
,
Deepak Palakshappa
2   Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
4   Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
5   Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
› Author Affiliations Funding The study was funded by U.S. Department of Health and Human Services, National Institutes of Health (TL1TR003136), and National Heart, Lung, and Blood Institute (K23HL146902). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Abstract

Background The patient portal allows patients to engage with their health care team beyond the clinical encounter. While portals can improve patient outcomes, there may be disparities in which patients access the portal by sociodemographic factors. Understanding the characteristics of patients who use the portal could help design future interventions to expand portal adoption.

Objectives This study aimed to (1) examine the socioeconomic factors, comorbid conditions, and health care utilization among patients of a large academic primary care network who are users and non-users of the patient portal; and (2) describe the portal functions most frequently utilized.

Methods We included all adult patients at Atrium Health Wake Forest Baptist who had at least two primary care visits between 2018 and 2019. Patients' demographics, comorbidities, health care utilization, and portal function usage were extracted from the electronic health record and merged with census data (income, education, and unemployment) from the American Community Survey. A myWakeHealth portal user was defined as a patient who used a bidirectional portal function at least once during the study period. We used multivariable logistic regression to determine which patient characteristics were independently associated with being a portal user.

Results Of the 178,720 patients who met inclusion criteria, 32% (N = 57,122) were users of myWakeHealth. Compared to non-users, users were more likely to be 18 to 64 years of age, female, non-Hispanic White, married, commercially insured, have higher disease burden, and have lower health care utilization. Patients residing in areas with the highest educational attainment had 51% higher odds of being a portal user than the lowest (p <0.001). Among portal users, the most commonly used function was messaging clinic providers.

Conclusion We found that patient demographics and area socioeconomic factors were associated with patient portal adoption. These findings suggest that efforts to improve portal adoption should be targeted at vulnerable patients.

Keywords

patient portal - academic medical center - ambulatory practice - electronic health record

Protection of Human and Animal Subjects

This study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles of Medical Research involving Human Subjects. The Wake Forest School of Medicine Institutional Review Board reviewed and approved the study and waived informed consent because it did not involve patient contact.


Supplementary Material



Publication History

Received: 12 May 2022

Accepted: 23 September 2022

Accepted Manuscript online:
27 September 2022

Article published online:
02 November 2022

© 2022. Thieme. All rights reserved.

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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