Appl Clin Inform 2022; 13(03): 692-699
DOI: 10.1055/s-0042-1751239
CIC 2021

Examining the Relationship between Health Literacy, Health Numeracy, and Patient Portal Use

Gennaro Di Tosto
1   CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Daniel M. Walker
1   CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
2   Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Cynthia J. Sieck
3   Center for Health Equity, Dayton Children's Hospital, Dayton, Ohio, United States
,
Lorraine Wallace
4   Department of Biomedical Education and Anatomy, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Sarah R. MacEwan
1   CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
5   Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Megan E. Gregory
1   CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
6   Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Seth Scarborough
1   CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Timothy R. Huerta
1   CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
2   Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
6   Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States
,
Ann Scheck McAlearney
1   CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States
2   Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States
› Author Affiliations
Funding This work was supported by the Agency for Healthcare Research and Quality grants R01 HS024091-01, R21 HS024349-01, and P30-HS024379.

Abstract

Objectives The objective of this study is to investigate the relationships between health literacy and numeracy (HLN) and patient portal use, measured in inpatient and outpatient settings.

Methods Using data collected as part of a pragmatic randomized controlled trial conducted across the inpatient population of a U.S.-based academic medical center, the present study evaluated the relationships between patients' perceptions of health literacy and their skills, interpreting medical information with metrics of engagement with patient portals.

Results Self-reported levels of HLN for patients in the study sample (n = 654) were not significantly associated with inpatient portal use as measured by frequency of use or the number of different inpatient portal functions used. Use of the outpatient version of the portal over the course of 6 months following hospital discharge was also not associated with HLN. A subsequent assessment of patients after 6 months of portal use postdischarge (response rate 40%) did not reveal any differences with respect to portal use and health numeracy; however, a significant increase in self-reported levels of health literacy was found at this point.

Conclusion While previous studies have suggested that low HLN might represent a barrier to inpatient portal adoption and might limit engagement with outpatient portals, we did not find these associations to hold. Our findings, however, suggest that the inpatient setting may be effective in facilitating technology acceptance. Specifically, the introduction of an inpatient portal made available on hospital-provided tablets may have practical implications and contribute to increased adoption of patient-facing health information technology tools.

Protection of Human and Animal Subjects

Conduct of this research was reviewed and approved by the Ohio State University's Institutional Review Board. Informed consent was obtained from all study participants.


Supplementary Material



Publication History

Received: 03 December 2021

Accepted: 23 May 2022

Article published online:
06 July 2022

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