Abstract
BackgroundPatient portals are frequently used in modern health care systems as an engagement and communication tool. An increased focus on the potential value of these communication channels to improve health outcomes is warranted.ObjectiveThis paper aimed to quantify the impact of portal use on patients’ preventive health behavior and chronic health outcomes.MethodsWe conducted a retrospective, observational cohort study of 10,000 patients aged 50 years or older who were treated at the University of Pennsylvania Health System (UPHS) from September 1, 2014, to October 31, 2016. The data were sourced from the UPHS electronic health records. We investigated the association between patient portal use and patients’ preventive health behaviors or chronic health outcomes, controlling for confounders using a novel cardinality matching approach based on propensity scoring and a subsequent bootstrapping method to estimate the variance of association estimates.ResultsPatient-level characteristics differed substantially between portal users, comprising approximately 59.32% (5932/10000) of the cohort, and nonusers. On average, users were more likely to be younger (63.46 years for users vs 66.08 years for nonusers), white (72.77% [4317/5932] for users vs 52.58% [2139/4068] for nonusers), have commercial insurance (60.99% [3618/5932] for users vs 40.12% [1632/4068] for nonusers), and have higher annual incomes (US $74,172/year for users vs US $62,940/year for nonusers). Even after adjusting for these potential confounders, patient portal use had a positive and clinically meaningful impact on patients’ preventive health behaviors but not on chronic health outcomes.ConclusionsThis paper contributes to the understanding of the impact of patient portal use on health outcomes and is the first study to identify a meaningful subgroup of patients’ health behaviors that improved with portal use. These findings may encourage providers to promote portal use to improve patients’ preventive health behaviors.
Highlights
BackgroundChronic conditions are the leading causes of death and disability and key drivers of total health care costs in the United States [1,2,3]
We evaluated the impact of the portal use on patient health outcomes by comparing the 4 preventive health behaviors and 4 chronic health outcomes between the portal users and nonusers
As both patient- and provider-level characteristics can potentially confound the associations between portal use and patient health outcomes, we adjusted for these potential confounders by adopting a recently developed cardinality matching approach based on propensity scores
Summary
Chronic conditions are the leading causes of death and disability and key drivers of total health care costs in the United States [1,2,3]. Objective: This paper aimed to quantify the impact of portal use on patients’ preventive health behavior and chronic health outcomes. Even after adjusting for these potential confounders, patient portal use had a positive and clinically meaningful impact on patients’ preventive health behaviors but not on chronic health outcomes. Conclusions: This paper contributes to the understanding of the impact of patient portal use on health outcomes and is the first study to identify a meaningful subgroup of patients’ health behaviors that improved with portal use. These findings may encourage providers to promote portal use to improve patients’ preventive health behaviors
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