Patient portal utilization: before and after stage 2 electronic health record meaningful use.

Abstract

Patient portal functionalities, such as patient-physician e-communication, can benefit patients by improving clinical outcomes. Utilization has historically been low but may have increased in recent years due to the implementation of Stage 2 Meaningful Use for electronic health records. This study has 2 objectives: 1) to compare patient portal utilization rates before Stage 2 (2011-2013) and after Stage 2 (2014-2017), and 2) to examine whether disparities in patient portal utilization attenuate after Stage 2. We conducted an observational study using a pooled cross-sectional analysis of 2011-2017 National Health Interview Survey data (n = 254 183). The mean percent use of patient portals significantly increased from the pre-Stage 2 to the post-Stage 2 period (6.9%, 95% CI, 6.2-7.5; P < .001). Non-Hispanic Black individuals (OR 0.81, 95% CI, 0.76-0.86; P < .0001) and Hispanic individuals (OR 0.79, 95% CI, 0.74-0.84; P < .0001) have lower odds of using patient portals compared to non-Hispanic White individuals. Although we found independent effects of race/ethnicity, we did not find a statistically significant interaction between race/ethnicity and time. We found a similar level of increase in patient portal utilization from the pre- to postperiod across racial and ethnic groups. Health care policies such as Stage 2 Meaningful Use are likely contributing to increased patient portal utilization across all patients and helping to attenuate disparities in utilization between subgroups of patients. Further research is needed to explore which patient portal functionalities are perceived as most beneficial to patients and whether patients have access to those functionalities.