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

Gennaro Di Tosto; Daniel M. Walker; Cynthia J. Sieck; Lorraine Wallace; Sarah R. MacEwan; Megan E. Gregory; Seth Scarborough; Timothy R. Huerta; Ann Scheck McAlearney

doi:10.1055/s-0042-1751239

Applied Clinical Informatics, Table of Contents

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

¹CATALYST, 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

¹CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States

²Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States

,

Cynthia J. Sieck

³Center for Health Equity, Dayton Children's Hospital, Dayton, Ohio, United States

,

Lorraine Wallace

⁴Department of Biomedical Education and Anatomy, College of Medicine, The Ohio State University, Columbus, Ohio, United States

,

Sarah R. MacEwan

¹CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States

⁵Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States

,

Megan E. Gregory

¹CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States

⁶Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States

,

Seth Scarborough

¹CATALYST, 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

¹CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States

²Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States

⁶Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States

,

Ann Scheck McAlearney

¹CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, United States

²Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States

› Author Affiliations

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.

Keywords

patient portals - health literacy - health numeracy - patient portal engagement

Full Text

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Supplementary Material

Supplementary Material