Appl Clin Inform 2019; 10(04): 670-678
DOI: 10.1055/s-0039-1695792
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Providing Access: Differences in Pediatric Portal Activation Begin at Patient Check-in

Ruth A. Bush*
1  Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, California, United States
2  Department of Urology, Rady Children's Hospital San Diego, San Diego, California, United States
,
Vijaya M. Vemulakonda*
3  Department of Pediatric Urology, Children's Hospital Colorado, Aurora, Colorado, United States
4  Division of Urology, Department of Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, United States
,
Andrew C. Richardson
5  Clinical Research Informatics, Rady Children's Hospital San Diego, San Diego, California, United States
,
Sara J. Deakyne Davies
6  Research Informatics and Analytics, Analytics Resource Center, Children's Hospital Colorado, Aurora, Colorado, United States
,
George J. Chiang
7  Department of Urology, University of California San Diego, San Diego, California, United States
8  Rady Children's Institute of Genomic Medicine, Rady Children's Hospital San Diego, San Diego, California, United States
› Author Affiliations
Funding This project was supported in part by the Agency for Healthcare Research and Quality (grant numbers R00 HS022404 [R.A.B.] and K08 HS024597–01 [V.M.V.] as well as by the American Urological Association Rising Stars in Urology Research Award Program and the Frank and Marion Hinman Urology Research Fund (V.M.V.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality, the American Urological Association, or the Frank and Marion Hinman Urology Research Fund.
Further Information

Publication History

23 April 2019

10 July 2019

Publication Date:
11 September 2019 (online)

Abstract

Background The patient portal interface with individual electronic health records (EHR) was introduced as a tool to enhance participatory medicine. Recent studies suggest adults from racial and ethnic minorities as well as non-English speakers face disproportionate barriers to adoption; however, little data are available for pediatric patients.

Objective The purpose of this study was to examine patient portal offers and activation patterns among pediatric urology patients at two geographically diverse tertiary pediatric hospitals.

Methods Retrospective analysis of 2011 to 2016 electronic portal audit records was conducted among patients aged 18 and younger with at least one outpatient urology clinic visit at two tertiary academic pediatric hospitals and their affiliated networks. Differences in utilization among parents/caregivers and adolescents were examined using multivariate analysis.

Results Of 44,608 individuals seen in a participating urology department during the study period, 21,815 (48.9%) were offered a code for patient portal activation; of these, 8,605 (19.3% of total eligible individuals) activated portal access. Logistic regression demonstrated associations between an offer and site (p < 0.001), being female (p < 0.001), being Asian or white (p < 0.05), being non-Hispanic (p < 0.001), and reporting English as preferred language (p < 0.001). Activating patient portal access was associated with site (p < 0.001), being Asian or white (p < 0.001), and reporting English as preferred language (p < 0.001).

Conclusion This study found that demographic variations in portal began with demographic differences in which patients were offered an activation code. Fewer than half of those given an access code activated their account. Preferred language, race/ethnicity, and clinic location were associated with likelihood of portal activation. Although patients are increasingly expected to schedule appointments, manage correspondence, request prescription refills, obtain authorizations and referrals, and communicate with the medical team using the portal, this study suggests that in the pediatric specialty setting many patients and caregivers are not offered the opportunity to access these tools.

Protection of Human and Animal Subjects

* Co-first coauthors.