Patient portals still largely unused, Health Affairs finds
- Patient portals can be important tools for increasing patient interaction with personal health data and fostering communication with providers, but only if patients are willing to use them. In a sample of U.S. adults, 63% reported not using a portal in the past year, a new Health Affairs study shows.
- Researchers from the University of Michigan School of Public Health and University of Wisconsin-Milwaukee analyzed data on 2,325 insured respondents to the 2017 Health Information National Trends Survey to understand who nonusers are and why they don't use portals.
- Nonusers tended to be male, on Medicaid, not have a regular doctor and have less higher education than portal users. Those trends also carried over to who was likely to be offered portal access, with fewer nonwhites reporting being given the option.
Patient portals are a frequent source of frustration for patients and providers. In a recent Ernst & Young survey, just 39% of doctors said they use patient portals. Still, a 2017 West survey found three-fourths of patients with chronic conditions want regular contact with their doctor so they can hear quickly if anything looks amiss.
A recent Journal of American Medical Informatics Association study suggested that teaching patients how to access a patient portal and the portal's role in their post-discharge care increases engagement both during and after hospitalization while improving the patient experience.
Reasons for not using a portal included lack of internet access, no online record, the desire to speak directly to providers and privacy concerns. Patients ages 40 and up and non-Hispanics of other races were more likely to cite privacy and security concerns than younger and non-Hispanic white patients. Meanwhile, Medicare and Medicaid patients were more likely to want to speak with their caregiver rather than get information via portal.
The researchers point to several policy implications of the study. While the CMS meaningful use program requires providers to give 80% of their patients access to a certified portal, the incentives don't focus on who is using them. Realigning incentives to encourage use by disadvantaged patients could reduce health disparities, they say.
Providers also need to step up their game to educate patients about technologies and ease privacy concerns.
"New communication practices to facilitate patient engagement work best in the context of engaged providers and trusting provider-patient relationships," the researchers write. "Careful monitoring of who is and who is not using new technologies, and why, and designing technologies to address patients' needs, will help ensure that such innovations do not exacerbate disparities but rather lead to improvements for all."