Abstract
Purpose: To assess whether individuals attending a community clinic had the necessary Internet access and experience to use the patient portal, while examining covariates of education, income, and self-perception of health with past and anticipated portal use.Methods: Adults attending an urban, community primary care clinic were invited to participate in a brief survey assessing current Internet access and use, past portal use, and anticipated future portal use. Survey responses were analyzed using descriptive and multivariate statistics.Results: One hundred fifteen participants ranging in age from 18 to 84 years (mean 42.1, standard deviation 17.1) completed the survey; 6 (5%) in Spanish. Thirty-five (30%) self-identified as Latino; 12 (10%) as Asian; and 20 (17%) as other. Almost 80% reported their health as good or better. Although 38% reported some college and 47% reported being college graduates, 60% reported household incomes were <$50,000. Most (87%) used the Internet for >1 year. Fewer than half (42%) had past portal use, with significant differences associated with weekly Internet use (Fisher's exact=9.59; p=0.02) and smart phone access (Fisher's exact=6.15; p=0.02). Computer Internet access was significantly associated with income (Fisher's exact=16.91; p<0.001). Logistic regression identified that computer Internet access was a significant predictor (odds ratio 9.9 (95% confidence interval: 1.7–58.8) of future portal use, controlling for smart phone use, health status, gender, and age.Conclusions: Among this highly educated but lower economic sample, computer Internet access and smart phone access were associated with past portal use and anticipated future use.
Highlights
The portal can be accessed using an online webpage and on a smart phone application following a two-stage activation, in which individuals can log into their account after receiving an initial system email with temporary login information generated at the individual’s request
With an overall chi-square of 30.34 ( p = 0.001), a Nagelkerke Rsquared of 0.42; and a classification of 89.4%, computer Internet access was the only significant variable in the model when controlling for the other independent variables
With females more likely than men to indicate anticipated future use
Summary
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted in 2009, supports the meaningful use of electronic health records (EHRs) to improve patient quality of care.[1,2] The patient portal is a secure online website providing patients 24 h access to the EHR, designed to facilitate patient engagement, increase self-management, improve patient and health provider communication outside of faceto-face visits, increase patient satisfaction from care received, and result in better clinical outcomes.[3,4,5] Patient portals allow individuals to send secure messages to clinical staff, view their health records (e.g., diagnoses, laboratory results, and medications list), schedule appointments, request prescription refills, and manage bills.[6]Because the portal can be an important tool for scheduling appointments, providing timely communication with providers, and improving understanding of medical conditions and their treatment, it may serve as an effective engagement tool.[7]. Patient portals have been demonstrated to do the following: improve medication adherence, disease awareness, and selfmanagement of disease, decrease office visits, increase preventative medicine, and increase office visit duration at the patient’s request for additional information.
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