Use Of Portal Research Articles

Examining Whether Patient Portal and Video Visit Use Differs by Race and Ethnicity Among Older Adults in a US Integrated Health Care Delivery System: Cross-Sectional Electronic Health Record and Survey-Based Study

Background Health care systems are increasingly encouraging patients to use patient portals and participate in video visits. However, there is limited information about how portal use differs among older adults. Objective This study aimed to understand how patient portal and video visit use differed by age, race, and ethnicity among older adult patients with access to the same digital health resources. Methods This cross-sectional study used electronic health record and survey data for adults aged 65 to 85 years who were members of a large Northern California health care delivery system throughout 2019 and 2020. The electronic health record cohort (N=471,152) included 320,686 White, 35,892 Black, 44,922 Latino, 20,786 Chinese, 28,732 Filipino, 8473 South Asian, 6716 Japanese, 2930 Vietnamese, and 2015 Korean adults. Racial and ethnic group and age group (65 to 75 years vs 76 to 85 years) differences in having a patient portal account by December 2020, the performance of 2 portal activities (sending ≥1 message to a clinician in 2019 or 2020 and viewing ≥1 laboratory test result in 2020), and having ≥1 video visit during 2020 were examined. Modified log-Poisson regression was used to examine prevalence ratios for portal and video visit use, comparing racial and ethnic groups to White adults and Asian ethnic groups to Chinese adults after adjusting for sex and age. Data from a 2020 member survey were used to compare internet use factors among 2867 White, 306 Black, 343 Latino, 225 Chinese, and 242 Filipino adults. Results Black, Latino, and Filipino adults were less likely to have a patient portal account than White adults, and Filipino adults were less likely to have a patient portal account than Chinese adults. Black, Latino, Filipino, Korean, Vietnamese, and South Asian adults were less likely to have sent messages and viewed test results than White adults, while Chinese and Japanese adults’ use of these features was similar to that of White adults. Filipino, Vietnamese, and Korean adults were less likely to have performed the aforementioned activities than Chinese adults. Video visit use was lower among Black and Latino adults and higher among Chinese and South Asian adults compared with White adults (aged 76 to 85 years) and lower among Filipino, Korean, and Vietnamese adults compared to Chinese adults. Survey data suggested that underlying differences in internet use may partially explain the lower use of messaging by Black, Latino, and Filipino adults compared with White and Chinese adults. Conclusions Patient portal and video visit use differed by race, ethnicity, and age group among older adult patients with access to the same patient portal. Internet use factors may contribute to these differences. Differences in patient portal and video visit use across Asian subgroups underscore the importance of disaggregating use data by Asian ethnicity.

A framework and pilot study for assessing usability of flood data portals for interdisciplinary research

There is a lack of datasets to study the climate and human outcomes nexus. There are many flood data portals due to recent improvements in flood identification using satellites, providing opportunities to study the human impacts. The development of these portals is rapid and there is currently no standard for evaluating their usability for interdisciplinary research. This paper addresses this important data gap. We put forth a usability framework that includes data availability, approaches to flood identification, alignment, velocity, variety, and user feasibility aspects. We piloted it through an in-depth review and user survey of NASA Worldview (NW), Global Flood Awareness System (GloFAS), Global Flood Monitoring System (GFMS), Global Surface Water Explorer (GSWE), and Dartmouth Flood Observatory (DFO) GSWE and GloFAS were rated most favorably. Respondents had discrepancies in their opinions on the clarity of the goals and platform accessibility for GFMS, DFO, and NW, and in data and visualization quality for all portals. Historical data and measures of flood recurrence and other characteristics are needed. Flood data products should be provided in multiple formats, aggregated by sub-national boundaries, with mechanisms that delineate incomplete or unreliable data. Flood data portals should include interdisciplinary research as part of their mission. Their longevity and maintenance should be secured to preserve these important data sources for future research. This framework can be adapted and used to enable interdisciplinary spatial and survey data linkages.

Disparities in Patient Portal Activation and Usage at a Large Pediatric Academic Institution.

Access to personal medical information promotes patient understanding of health issues and enables patient self-advocacy of healthcare needs. The advent of electronic medical record systems and the 2016 21st Century CURES Act promoted and encouraged patient access to personal medical information, yet technology-dependent modalities have often disadvantaged certain communities. We sought to evaluate whether disparities existed in access to patient portals at our institution, the main pediatric care provider in an area serving one million children. We evaluated the activation of patient portal accounts at our institution over the past decade (2010-2021). Portal activation data were analyzed by ethnic background and language preference and income information available based on primary home access location. Further, we evaluated portal activation rates over time and across institutional interventions. A logistic regression model was used to identify important demographic associations with portal account status. Over 1 million patients were served at our pediatric institution over the study period with 47.7% having ever activated their patient portals. Univariate analyses and ultimately logistic regression modeling demonstrated significant differences in portal activation by ethnicity (odds ratio (confidence interval):1.36 (1.34, 1.37)), language preference (1.39 (1.37, 1.40)), and median household income (1.00001 (1.00001, 1.00001)). Interim interventions were successful in improving portal activation rates. Overall, electronic medical record portal activation was less prevalent among Hispanic, non-English speakers, and patients living in communities with lower median household income. Opportunities for interventions exist to reduce healthcare disparities in these underserved communities.

Efektivitas YouTube Sebagai Alat Pencarian Informasi Untuk Diversifikasi Produk Stroberi pada UMKM Desa Lebakmuncang Ciwidey

The village of Lebakmuncang in Ciwidey has become a center for strawberryproduction, with the majority of its residents relying on agriculture and plantations.However, many Micro, Small, and Medium Enterprises (MSMEs) in this village still relyon fresh products without taking advantage of the potential for diversification intoprocessed products such as jams, juices, and snacks. Product diversification has becomean important strategy to enhance the competitiveness and sustainability of MSMEs (Micro,Small, and Medium Enterprises). YouTube, as the largest video-sharing platform, offers information that can assist small and medium enterprises (SMEs) in productdiversification. However, challenges arise in measuring the effectiveness of this platformin the context of strawberry product diversification. This research aims to analyze theeffectiveness of YouTube as a source of information and to assess the impact of thatinformation on the product diversification decisions of strawberry SMEs in LebakmuncangVillage, Ciwidey. The results indicate that YouTube has proven to be an effective source ofinformation for strawberry product diversification. All the indicators studied yieldedpositive results, with the usefulness of information being the most important factor. Theinformation available on YouTube has a significant impact on the diversification of MSMEproducts, allowing them to learn, innovate, and reach new audiences. This researchrecommends that SMEs make optimal use of YouTube, encourage content creators toprovide more relevant information, and suggest improvements to the portal design toenhance user experience. The development of strawberry SMEs in Lebakmuncang Village,Ciwidey, is expected to enhance the economic welfare of the local community and make themost of local potential.

A tale of two patients – How did the pandemic impact patients’ usage of health portals

Objective: The study examines whether patient health portal usage significantly increased during the COVID-19 pandemic between 2019 and 2022.Methods: In order to measure patient usage of patient portals before and during the first year of the COVID-19 pandemic, this study used the Health Information National Trends Survey results for 2019, 2020, 2021, and 2022. It was compared, using a least square regression model, to see if there was a significant relationship between increased use of telehealth, the usage of health portals, and the number of times seen by a regular healthcare provider.Results: The number of patients who saw their health care provider thrice a year and used their patient portal pre- and postpandemic increased. However, the overall increase in patients using their portals before and during the first two years of the pandemic remains below 50%.Conclusions: Overall, the pandemic increased patients’ use of telemedicine but only significantly increased their usage of patient portals for those patients who saw their provider three or more times a year. These findings indicate that more interaction with providers might impact future portal usage.

Osgood-Schlatter Disease in an Adult Athlete: A Case Report and Review of the Literature

Background: Osgood-Schlatter disease (OSD), a form of traction apophysitis, predominantly affects adolescents engaged in high- impact activities. While conservative management is often effective, surgical intervention becomes necessary in refractory cases. Case Report: A 29-year-old male athlete with persistent OSD symptoms underwent arthroscopic surgery after unsuccessful non- surgical treatments. Arthroscopic removal of the bony particle was undertaken using six portals with a novel setting (consisting of medial and lateral superior, standard, and inferior portals) to minimize the damage to the patellar tendon and intermeniscal ligaments. This setting of portals also obviates the need for fluoroscopy since it provides adequate visualization for confirmation of complete removal of the bony particle. The lower portals also provide more convenient access to the bony particle, minimizing the possibility of incomplete removal and persistence of symptoms. The patient experienced complete resolution of anterior knee pain and prominence within six months post-surgery. Arthroscopic removal of the ossicle involved the use of superior portals for optimal access and visualization. Low portals were strategically employed to eliminate the need for fluoroscopy, offering a unique advantage. Postoperative rehabilitation included immobilization followed by a gradual return to weight-bearing and full range of motion (ROM). Conclusion: Arthroscopic removal remains the preferred method for treating OSD, emphasizing fewer complications. However, challenges related to limited access and anatomical restoration persist.

Digital Health Tools and Behavioral Strategies to Increase Engagement With Diabetes Self-Management Education and Support: Design and Feasibility of DM-BOOST.

The purpose of the study was to describe the development and feasibility of implementing the DM-BOOST program in support of an established diabetes self-management education and support (DSMES) program. A patient panel of 4 adults with type 2 diabetes (T2DM) codesigned DM-BOOST. DM-BOOST is a patient-focused program that includes peer-written text messages about diabetes self-management behaviors and digital health training to improve patient portal use and initiate goal setting prior to a scheduled DSMES appointment. Adults with T2DM and A1C ≥8.0% participated in a 6-month feasibility pilot. Participants were randomly assigned (1:1) to receive either DM-BOOST or usual care. Outcomes included DSMES engagement (scheduled and attended DSMES appointments) and changes in diabetes self-efficacy and treatment satisfaction. Pilot participants (n = 60) were 60.0% female with mean age 45.5 years (SD 8.3) and A1C 10.1% (SD 1.8%). All DM-BOOST participants (30/30, 100%) had DSMES appointments scheduled compared to 86.7% of usual care (26/30). DM-BOOST participants had fewer DSMES appointment no-shows/cancellations (3/30, 10%) compared to usual care (10/26, 35%). There was greater improvement in diabetes self-efficacy in the DM-BOOST group compared to usual care and no difference in treatment satisfaction. DM-BOOST, leveraging peer-written text messaging and digital health training, increased DSMES engagement. Implementation of DM-BOOST was determined to be feasible, with several system-level barriers identified, including obtaining provider referrals and scheduling appointments. An effectiveness trial of DM-BOOST is needed to evaluate the impact on clinical outcomes.

Implementation of an electronic patient portal in routine mental health care of hospitals in Germany – evaluation of attitudes of healthcare providers

BackgroundThe use of digital tools such as electronic patient portals in different health care disciplines and settings has been increasing, but the rate of implementation in clinical practice still lags behind expectations. While studies have linked the use of electronic patient portals to positive health outcomes for patients, studies addressing the viewpoints of healthcare providers are rare.MethodsWe performed an online survey of attitudes of healthcare providers towards an electronic patient portal for mental health hospitals. The portal was developed by five communal providers of mental health care in different regions in Germany. The survey was carried out during the early phase of implementation of the portal.ResultsTwenty project leaders and 37 clinicians from five different mental health hospitals answered the questionnaire (response rate: 45% and 28%). Overall, acceptance of online applications among respondents was high. The healthcare providers mentioned perceived benefits (e.g. accessibility of new patient groups, use of therapy-free periods) as well as a number of technical, structural, organizational and staffing barriers for successful implementation in hospital settings (e.g. workload of healthcare providers and lack of staff, limited digital competences, unstable WLAN).ConclusionThe perceived barriers and facilitators of the implementation of online applications and electronic patient portals in mental health hospitals identified by healthcare providers may be taken into account. Improving commitment of the healthcare providers to implementation and use of digital interventions may help foster digitalisation in mental health hospitals.

A Tale of 102,726 Messages: Characterizing the Modern Urologist's Portal Message Burden After Common Urologic Surgeries.

We aimed to characterize patient portal messaging use after urologic surgery to identify administrative burden and evaluate postoperative clinical associations. Epic was queried for all urologic surgeries performed at the Mayo Clinic enterprise between 2019 and 2022. Data from the highest volume procedures were extracted including patient-generated portal messages to their provider and emergency department (ED) visits within 6 months of surgery. Factors associated with portal users and message volume, as well as the impact of portal use on risk of subsequent ED visit, were evaluated. We analyzed data from 23,621 urologic procedures, which generated 102,726 patient portal messages within 6 months of surgery. We found that 55% of our cohort sent at least 1 message. Stratifying by subspecialty, endourologic surgeries generated the fewest number of messages per surgery (3.83; SD, 8.76), whereas female pelvic medicine and reconstructive surgeries yielded the most (6.05; SD, 10.92). Younger age, female sex, and White race were associated with increased portal utilization. Multivariable time-to-event analysis revealed a 33% reduction in the risk of ED presentation within 90 days after surgery for patients using the patient portal compared with those who did not. While only half of patients sent portal messages after surgery, active users showed a 33% reduction in ED visits, suggesting its potential to reduce health care utilization. Encouraging broader portal adoption can improve outcomes. However, the message burden for urologists necessitates solutions. Resource allocation should prioritize strategies to help urologists manage messages while preserving the established clinical benefits.

Educational and Career Trajectories in Russia: Introducing a New Source and Datasets with a High Granularity

Abstract Studying Russian society is challenging, especially during the period of the Russian military invasion. However, it takes on special significance during a period of economic and social transformation. Studying the career and educational trajectories of Russians in the context of East Studies offers a multifaceted perspective on the state of the job market and education sector and gives an understanding of the current situation of the country’s economy and social structure. The lack of data with a high level of granularity is critical, especially for studying people with a focus on their career and educational trajectories. In this article, the authors respond to this request and present two datasets that can be useful for studying spatial and temporal patterns associated with people’s life trajectories in the context of work and education. The authors utilised open data on cv s created or updated by employment portal users over the period 2015–2023 from the Federal Service for Labor and Employment (Rostrud) and prepared two cleaned datasets covering 83 regions of Russia. Dataset 1 is on the educational and career trajectories (N = 6,221,439) and Dataset 2 is on the activity of unemployed and job-seeking candidates (N = 7,662,089).

Use of the Patient Portal to Discuss Medications Among People with Dementia and Their Care Partners.

People with dementia (PWD) often use potentially inappropriate medications (PIM), exposing them to harm. Patient portals are a promising platform for delivering deprescribing educational interventions to reduce PIM use, yet little is known about how PWD and their care partners use patient portals to communicate with clinicians about medications. To characterize the content of patient portal messages relating to medications among PWD, care partners, and clinicians, to inform development of a portal-based intervention to reduce use of PIM among PWD. Descriptive analysis of data from the electronic health record and qualitative analysis of patient portal messages. Adults 65 and older, categorized as having dementia based on EHR algorithm, who received care in an academic health system from 2017 to 2022. Electronic health record data were analyzed using descriptive statistics. Qualitative coding identified topics raised in portal messages. A total of 399 message threads from 159 unique patients were analyzed. Patients were on average 78.4 years old (SD 8.0). Most (65%) were female, White (76%), and non-Hispanic/Latinx (96%); 15% had a registered proxy portal user. The most common topics raised in portal messages were logistics (42%), concerns about adverse effects/treatment burden (25%), asking for new medications (23%), and openness to stopping medications (21%). Qualitative analysis revealed three main themes related to deprescribing: (1) Opportunities to deprescribe, (2) challenges to deprescribing, and (3) medication-related counseling in the portal. PWD and their care partners frequently raise medication concerns in the portal, suggesting it is a promising platform for delivering deprescribing interventions for this population. Future research should identify characteristics of portal-based interventions that would best support deprescribing for PWD and develop pragmatic workflows.

Developing A Tourism Information Portal Using Web Technologies and Database Management

The quality and variety of the infrastructure at a place has a big impact on tourism. An essential component of the tourism sector, infrastructure has a unique influence on the growth of this rapidly developing sector. Many nations have realised how important infrastructure is to the travel and tourist sector, and as a result, their governments have partnered with the sector to provide infrastructure that is specifically needed for travel. The sites that draw tourists in the first place, where tourism is delivered, where businesses are located, and where tourists consume the product are all considered destinations. The design and implementation of a tourism information portal using web technologies and database administration is presented in this study. The portal's goal is to give travellers a thorough and intuitive way to get information about travel destinations, lodging options, and activities. Database design, web application development, and the integration of pertinent technologies like HTML, CSS, JavaScript, and PHP are all part of the development process. User testing and feedback are used to assess the portal's usability and functionality. The outcomes show how successful the portal is at delivering precise and current information, improving the traveler experience, and encouraging destination management. The study emphasises the use of web technologies and database management in tourism marketing and management, and it advances the development of tourism information systems.

Recommendations to Address Barriers to Patient Portal Use Among Persons With Diabetes Seeking Care at Community Health Centers: Interview Study With Patients and Health Care Providers.

Community health centers (CHCs) are safety-net health care facilities in the United States that provide care for a substantial number of low-income, non-English speaking adults with type 2 diabetes (T2D). Whereas patient portals have been shown to be associated with significant improvements in diabetes self-management and outcomes, they remain underused in CHCs. In addition, little is known about the specific barriers to and facilitators of patient portal use in CHCs and strategies to address the barriers. The objectives of this qualitative study were to explore the barriers to and facilitators of the use of patient portals for managing diabetes in 2 CHCs from the perspective of adults with T2D and clinicians (community health workers, nurses, nurse practitioners, and physicians) and to make recommendations on strategies to enhance use. A qualitative description design was used. A total of 21 participants (n=13, 62% clinicians and n=8, 38% adults with T2D) were purposively and conveniently selected from 2 CHCs. Adults with T2D were included if they were an established patient of one of the partner CHCs, aged ≥18 years, diagnosed with T2D ≥6 months, and able to read English or Spanish. Clinicians at our partner CHCs who provided care or services for adults with T2D were eligible for this study. Semistructured interviews were conducted in either Spanish or English based on participant preference. Interviews were audio-recorded and transcribed. Spanish interviews were translated into English by a bilingual research assistant. Data were collected between October 5, 2022, and March 16, 2023. Data were analyzed using a rapid content analysis method. Standards of rigor were implemented. Themes generated from interviews included perceived usefulness and challenges of the patient portal, strategies to improve patient portal use, and challenges in diabetes self-management. Participants were enthusiastic about the potential of the portal to improve access to health information and patient-clinician communication. However, challenges of health and technology literacy, maintaining engagement, and clinician burden were identified. Standardized implementation strategies were recommended to raise awareness of patient portal benefits, provide simplified training and technology support, change clinic workflow to triage messages, customize portal notification messages, minimize clinician burden, and enhance the ease with which blood glucose data can be uploaded into the portal. Adults with T2D and clinicians at CHCs continue to report pervasive challenges to patient portal use in CHCs. Providing training and technical support on patient portal use for patients with low health literacy at CHCs is a critical next step. Implementing standardized patient portal strategies to address the unique needs of patients receiving care at CHCs also has the potential to improve health equity and health outcomes associated with patient portal use.

Patient- and Provider-Level Factors Associated with Patient Portal Usage Among Medicaid Recipients.

Background: Patient portals can improve access to electronic health information and enhance patient engagement. However, disparities in patient portal utilization remain, affecting disadvantaged communities disproportionately. This study examined patient- and provider-level factors associated with portal usage among Medicaid recipients in a large federally qualified health center (FQHC) network in Texas. Methods: Deidentified electronic medical records of patients 18 years or older from a large Texas FQHC network were analyzed. The dependent variable was a binary flag indicating portal usage during the study period. Independent variables included patient- and provider-level factors. Patient-level factors included sociodemographic, geographic, and clinical characteristics. Provider characteristics included primary service line, provider type, provider language, and years in practice. Because the analysis was at the individual level, a multivariable logistic regression model focused on adjusted associations between independent variables and portal usage. Results: The analytic sample consisted of 9,271 individuals. Compared with individuals 18-39 years, patients 50 years and older had lower odds (50-64 OR: 0.60, p < 0.001; 65+ OR: 0.51, p < 0.001) of portal usage. Males were less likely to use portals (OR: 0.44, p = 0.03), and compared to Non-Hispanic Whites, Non-Hispanic Black (OR: 0.86, p = 0.02) and Hispanics (OR: 0.83, p < 0.001) were significantly less likely to use portals. Individuals with 1 or more telemedicine consults had a two-times greater odds of portal usage (OR: 1.97, p < 0.001). Compared to individuals who had clinic visits in December 2018, portal usage was significantly higher in the pandemic months (March 2020-November 2020, all p's < 0.01). Importantly, the behavioral health service line had the greatest odds (OR: 1.52, p < 0.001), whereas the dental service line had the lowest odds (OR: 0.69, p = 0.01) compared to family practice. No other provider characteristics were significant. Conclusion: Our finding of significant patient-level factors is important and can contribute to developing appropriate patient-focused health information technology approaches to ensure equitable access and maximize the potential benefits of patient portals in health care delivery.

Abstract P185: Patient Portal Access, Health Literacy, Patient Trust in Health System, and Shared Decision Making Among US Adults with Hypertension: A National Cross-Sectional Study

Background: Shared decision-making (SDM) is increasingly recognized as central to delivering patient-centered care and improving hypertension control. However, there is limited understanding of the association between patients' access to patient portals, health literacy, trust in the health system, and involvement in SDM. Objectives: This study investigated the associations between patients' access to patient portals, health literacy, trust in the health system, and patients’ involvement in SDM among adults with hypertension in the United States (US). Methods: This cross-sectional study utilized data from the 2022 Health Information National Trends Survey (HINTS 6) conducted among US adults. The exposure variables were patient portal use, health literacy, patients' trust in health systems, and whether the participant was offered access to patient portals by healthcare providers. The outcome of interest was whether patients were always involved in SDM (Yes/No) during the past 12 months. Analyses were weighted according to HINTS 6 methodology. We performed three weighted sequential multivariable logistic regression models (Fig. 1, Models 1-3). The fully adjusted model included demographics, clinical characteristics, and social determinants of health and resources for implementing SDM and was stratified by age (&lt;65 and ≥65 years). Results: We included 1703 adults with hypertension (mean age of 61.6, SD 13.9 years; 52.5% male; and 64.9% White adults). About 86.4% of participants were offered online access to patient portals by their healthcare providers. In the fully adjusted model (Fig. 1, Model 3), adults who were offered access to patient portals (adjusted odds ratio [aOR] 1.90, 95% CI 1.03-3.49), with higher health literacy levels (aOR 2.18, 95% CI 1.42-3.34), and with higher trust in health systems (aOR 3.08, 95% CI 2.26-4.21) were more likely to engage in SDM than their counterparts. These associations were similar among adults &lt;65 years (Fig. 2). However, among adults ≥65 years, offering online access to patient portals was not associated with involvement in SDM; while those who used the patient portal 6-9 times during the past 12 months were more likely to engage in SDM than those who never used it (aOR 2.26, 95% CI 1.06-4.83). Conclusion: Offering access to patient portals may enhance SDM among US adults with hypertension, especially for adults with higher health literacy levels and greater trust in health systems. These associations differed by age.

Abstract P186: Current practices and interest in mobile health among individuals with or at risk for hypertensive disorders of pregnancy

Background: The integration of smartphones, mobile health (mHealth) apps, and digital therapeutics into healthcare has transformed remote monitoring and patient-provider communication. Such technologies are currently underutilized, but could provide value to those in need of more frequent monitoring. Pregnant individuals with or at risk for hypertensive disorders of pregnancy (HDP) could potentially benefit from this technology. Methods: Pregnant individuals, ages 20-50, with a diagnosis of or risk factors for HDP, were recruited from a large academic medical center from June 2020 to January 2024 to complete an electronic survey. Data on sociodemographic variables, smartphone/wearable device use, health app and patient portal (MyChart) use, and interest in mHealth apps were collected. Statistical analysis was done using STATA/BE 18.0. Results: Of the 103 participants, the mean age was 31.9 (SD 5.5) years, 44.6% were Hispanic or Black, and 98.1% used smartphones ( Table ). Individuals over age 30 had lower smartphone use than those under 30 (p=0.04) and most with a smartphone had mhealth apps (64.4%). Interest in wearing a smartwatch for remote monitoring and communicating with providers via a secure mhealth app was high among participants (88.3% and 78.6% respectively). No significant differences in these interests were observed by race, age, and residence (urban/suburban vs. rural). Conclusion: Pregnant individuals with or at risk for HDP demonstrated high interest in using mhealth applications and smartwatches for communication with providers and remote monitoring. Effectively integrating these technologies into patient care may enhance access to and increased engagement with care among individuals with high-risk pregnancies.

How to Tell Whether Patients Engage and Use a Patient Portal - An Analysis of Five Functions.

The road to a more sustainable healthcare system includes creating a digital interface to the healthcare system that patients can use to engage in their health problems while outside the consultation room. The aim of the study was to evaluate trends in the use of functions in a patient portal and assess which functions were most likely to contribute to sustainable healthcare. Open, uncontrolled retrospective analysis of citizens' use of the patient portal. Extraction and statistical analysis of log data. Log analysis revealed that patients engaged with the patient portal to make appointments, fill out and submit questionnaires, send messages to their care provider, inspect their laboratory results, and view notes about themselves. The functions that displayed a significantly increasing trend were the number of appointments made, the number of messages sent, and the number of checked test results. While portal engagement can reduce patient dependency on healthcare services, external factors also influence this outcome. Further research is needed to investigate which functions support healthcare sustainability and enhance patient empowerment, possibly through other study designs.

Factors Associated with Completeness of Sex and Gender Fields in Electronic Health Records.

Purpose: Our purpose was to understand the completeness of sex and gender fields in electronic health record (EHR) data and patient-level factors associated with completeness of those fields. In doing so, we aimed to inform approaches to EHR sex and gender data collection. Methods: This was a retrospective observational study using 2016-2021 deidentified EHR data from a large health care system. Our sample included adults who had an encounter at any of three hospitals within the health care system or were enrolled in the health care system's Accountable Care Organization. The sex and gender fields of interest were gender identity, sex assigned at birth (SAB), and legal sex. Patient characteristics included demographics, clinical features, and health care utilization. Results: In the final study sample (N = 3,473,123), gender identity, SAB, and legal sex (required for system registration) were missing for 75.4%, 75.8%, and 0.1% of individuals, respectively. Several demographic and clinical factors were associated with having complete gender identity and SAB. Notably, the odds of having complete gender identity and SAB were greater among individuals with an activated patient portal (odds ratio [OR] = 2.68; 95% confidence interval [CI] = 2.66-2.70) and with more outpatient visits (OR = 4.34; 95% CI = 4.29-4.38 for 5+ visits); odds of completeness were lower among those with any urgent care visits (OR = 0.80; 95% CI = 0.78-0.82). Conclusions: Missingness of sex and gender data in the EHR was high and associated with a range of patient factors. Key features associated with completeness highlight multiple opportunities for intervention with a focus on patient portal use, primary care provider reporting, and urgent care settings.

Associations between patient portal use and electronic health record (EHR) data timeliness in type 2 diabetes mellitus care

Abstract Objective Patient data is subject to missingness and errors. Patient portals enable patients managing type 2 diabetes mellitus (T2DM) to review and correct data to avoid retesting, medication errors, and diagnostic mistakes. We examined whether patient portal use was associated with electronic health record (EHR) data timeliness in T2DM care. Research Design and methods We analyzed EHR data from a panel of adult patients to determine whether portal use improved data timeliness. EHR data timeliness is measured as the number of days between patient encounters, accounting for mean attribute update periods, where available EHR attribute updates for T2DM measurements were present, including body mass, weight, glycated hemoglobin A1c, cholesterol, blood pressure, serum creatinine, and smoking status. We performed negative binomial regressions with fixed effects to estimate the association between patient portal use and EHR data timeliness. Sensitivity analyses were conducted using Poisson regressions. Results Nearly a third (31.3%) of patients in our sample actively used the health portal. There were fewer days (111.9 days vs. 136.7 days; p &lt; 0.001) between EHR attribute updates for patients who used health portals compared to patients who did not. Data timeliness was lower among female, non-Hispanic White Medicare beneficiaries. Based on regression analyses, portal use was associated with an expected 3.6 (p &lt; 0.001) percentage point decrease in days between attribute updates, indicating improved EHR timeliness. Conclusion Improving the quality of health information may streamline decision-making in partnership with patients who produce data points across clinical settings. Active use of patient portals and digital health tools in chronic disease care are critical for care management and clinical decision-making, especially for patients managing type 2 diabetes across clinical settings.

Factors Associated with Uptake of Patient Portals at a Federally Qualified Health Care Center.

Federally qualified health centers (FQHC) aim to improve cancer prevention by providing screening options and efforts to prevent harmful behavior. Patient portals are increasingly being used to deliver health promotion initiatives. However, little is known about patient portal activation rates in FQHC settings and the factors associated with activation. This study examined patient portal activation among FQHC patients and assessed correlations with demographic, clinical, and health service use variables. We analyzed electronic health record data from adults >18 years old with at least one appointment. Data were accessed from the electronic health records for patients seen between 1 September 2018 and 31 August 2022 (n = 40,852 patients). We used multivariate logistic regression models to examine the correlates of having an activated EPIC-supported MyChart patient portal account. One-third of patients had an activated MyChart portal account. Overall, 35% of patients with an activated account had read at least one portal message, 69% used the portal to schedule an appointment, and 90% viewed lab results. Demographic and clinical factors associated with activation included younger age, female sex, white race, English language, being partnered, privately insured, non-smoking, and diagnosed with a chronic disease. More frequent healthcare visits were also associated with an activated account. Whether or not a patient had an email address in the EHR yielded the strongest association with patient portal activation. Overall, 39% of patients did not have an email address; only 2% of those patients had activated their accounts, compared to 54% of those with an email address. Patient portal activation rates were modest and associated with demographic, clinical, and healthcare utilization factors. Patient portal usage to manage one's healthcare needs is increasing nationally. As such, FQHC clinics should enhance efforts to improve the uptake and usage of patient portals, including educational campaigns and eliminating email requirements for portal activation, to reinforce cancer prevention efforts.