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How Does Patient Portal Use Affect Various Patient Populations?

New research shows that patient portal use differs among patients of varying socioeconomic statuses. This may have an effect on patient health.

New research indicates that low patient portal use rates in minority and poor patients may lead to overall poorer health.

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The study, led by researcher William Manard, MD, sought to determine if patient portal use can help patients lower their blood pressure. What Manard and his team found, however, was how socioeconomic status influenced patient portal adoption and overall patient health.

Between 2008 and 2010, the team enrolled 1571 patients with hypertension in a patient portal program. Over the next five years, the team collected follow-up data to test whether participants had reached their target blood pressure control, and also examined the effect of patient portal use on that achievement.

After adjusting their results for sociodemographic factors, the researchers saw trends in how socioeconomic status affected patient portal use and health.

After dividing the patients into four economic tiers, the researchers found that only 18.2 percent of patients on the lowest socioeconomic rung, and 19 percent of those on the second lowest rung, used the patient portal. Likewise, they had lower rates of blood pressure control rates.

Conversely, 35.8 and 27 percent of patients in the highest two socioeconomic levels had adopted the portal, and they also saw higher rates of blood pressure control rates.

The researchers also identified patterns in practice culture that influence patient portal use. Patients visiting general internists had lower rates of patient portal use than those visiting family medicine practices. This is likely due to the patient-centered medical home model used in many family medicine practices.

Because PCMHs emphasize communication and patient engagement, the researchers say it is not surprising that these patients had higher patient portal use rates.

These findings about socioeconomic status and practice culture show that targeted education about the portal is necessary for more success.

“Targeted interventions to disadvantaged minority patients may include education about portal communication, but this will only be effective if access to the Internet is equitable,” the authors said.

The researchers explained that their findings open new doors to further research, including studies about which populations benefit from the portal.

These results are consistent with the growth of patient portal use. Although some providers praise patient portals for making their jobs easier and engaging their patients, other research shows a different reality.

One survey published in May by HealthMine shows that although 60 percent of patients have access to a patient portal, only 20 percent actively use them to make medical decisions.

Another study, led by researcher Srinivas Emani, MA, PhD, showed that patients foremost use portals to review their data. Rarely do patients use patient portals to start a conversation with their providers.

Some researchers believe that patient portals are not being discussed often enough, and patient education on the matter is lacking.

“It is possible that the use of the [after visit summary] to engage patients in their health care is not being promoted,” said Emani and the team.

“Such efforts can lead to patient activation and the use of information by patients to undertake recommended treatment plans and self-management, both of which are important goals for the AVS.”

This may be due to where patient portals are in the adoption process, according to HealthMine president and CEO Bryce Davis.

"Electronic health records are still in the early phases of consumer adoption. They have the potential to engage consumers more directly in managing their health,” Davis explained. "Wellness programs can help bridge the gap between EHR adoption and understanding by making the information both meaningful and actionable for patients."

For patient portals to be most effective, providers are going to have to get more on board and better education their patients. This will ideally lead to better patient engagement and, ultimately, better chronic disease management and quality healthcare.

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