Use of an Electronic Patient Portal Among Disadvantaged Populations
Use of an Electronic Patient Portal Among Disadvantaged Populations
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DOI：
10.1007/s11606-011-1749-y
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发表时间：
2011-10-01
影响因子：
5.7
通讯作者：
Calman, Neil
中科院分区：
文献类型：
--
作者：
Ancker, Jessica S.;Barron, Yolanda;Calman, Neil
背景：电子患者门户使患者能够访问其电子健康记录中的信息，并能够向其提供者发送消息。这些工衡量标准：收到门户访问代码、激活帐户以及多次使用门户的几率 主要结果：在研究的 2 年中，16% 的患者 (n = 11,903) 收到了访问代码。其中，60% (n = 7138) 激活了该帐户，49% (n = 5791) 使用该帐户两次或多次。慢性病患者更有可能获得访问代码并成为重复用户。此外，白人、女性、年轻患者、说英语的人和被保险人获得访问代码的几率明显更高。与没有保险相比，在拥有激活帐户的人中，重复使用门户网站的几率随着白人种族、英语、私人保险或医疗补助的增加而增加。种族差异很小，但在控制语言、保险和健康状况的模型中仍然存在。结论：我们发现，在电子患者门户部署的头两年中，在主要是低收入人群中，尤其是慢性病患者中，其早期采用和使用率很高。门户网站的访问和使用方面的差异很明显，但比最近报告的其他人群中的差异要小。需要继续努力确保门户网站可供弱势群体使用，以便所有患者都能从这些技术中平等受益。
BACKGROUND: Electronic patient portals give patients access to information from their electronic health record and the ability to message their providers. These tools are becoming more widely used and are expected to promote patient engagement with health care.OBJECTIVE: To quantify portal usage and explore potential differences in adoption and use according to patients' socioeconomic and clinical characteristics in a network of federally qualified health centers serving New York City and neighboring counties.DESIGN: Retrospective analysis of data from portal and electronic health records.PARTICIPANTS: 74,368 adult patients seen between April 2008 and April 2010.MAIN MEASURES: Odds of receiving an access code to the portal, activating the account, and using the portal more than onceKEY RESULTS: Over the 2 years of the study, 16% of patients (n = 11,903) received an access code. Of these, 60% (n = 7138) activated the account, and 49% (n = 5791) used the account two or more times. Patients with chronic conditions were more likely to receive an access code and to become repeat users. In addition, the odds of receiving an access code were significantly higher for whites, women, younger patients, English speakers, and the insured. The odds of repeat portal use, among those with activated accounts, increased with white race, English language, and private insurance or Medicaid compared to no insurance. Racial disparities were small but persisted in models that controlled for language, insurance, and health status.CONCLUSIONS: We found good early rates of adoption and use of an electronic patient portal during the first 2 years of its deployment among a predominantly low-income population, especially among patients with chronic diseases. Disparities in access to and usage of the portal were evident but were smaller than those reported recently in other populations. Continued efforts will be needed to ensure that portals are usable for and used by disadvantaged groups so that all patients benefit equally from these technologies.