PatientEngagementHIT

Patient Portal Adoption Rates Hinge on Age, Ethnicity

Older patients have lower patient portal adoption rates, as do Hispanic, black, and Filipino patients, according to a recent study.

When it comes to patient portal adoption rates, age and ethnicity seem to make a difference.

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In a recent study out of Kaiser Permanente Northern California, researchers Nancy P. Gordon, ScD, and Mark C Hornbrook, ScD, found that older patients who are of Hispanic, black, or Filipino ethnicity tend to have lower patient portal adoption rates.

Overall, 80 percent of patients aged 65 to 79 reported having access to internet, email, computer, mobile phones, and were using the patient portal. These numbers are pretty promising, considering the fact that several in the healthcare industry have claimed that it is far more difficult to get older patients to adopt patient portals.

Breaking those numbers down by ethnicity tells a different story. The data showed that Hispanic, black, and Filipino patients were significantly less likely to use patient portals than their non-Hispanic white and Chinese counterparts.

Such results proved interesting, as Gordon and Hornbrook noted. Although the pair included both Filipino and Chinese patients to account for a portion of the Asian population receiving care at Kaiser Permanente Northern California, the two had varying results for patient portal usage. This divergence shows that putting the two into the same category may be inaccurately portraying that patient cohort.

“These two ethnic groups are usually combined along with other Asian ethnicities into a broad ‘Asian’ race/ethnic group,” Gordon and Hornbrook explained. “Our results suggest that doing so may be misleading for purposes of planning roll-outs of services and dissemination of health information, resulting in inequities across multiple Asian subgroups.”

Similarly, the researchers found that age played a significant factor in patient portal use and adoption. Those patients age 70 to 79 were far less likely to adopt the patient portal compared to their counterparts age 65 to 70.

Those patients age 70 to 79 who did happen to register for their patient portals were also less likely to actually use it compared to other patients included in the study.

This lack of adoption may have a lot to do with patient’s access to technology. Although a near 80 percent of respondents reported having access to technology, including a patient portal, most of those respondents were white and fell into a younger patient cohort. Looking at access to technology for older patients who are of different ethnicities tells a different story.

For example, Hispanic, black, and Filipino patients were less likely to have access to health technology. Because they did not have a computer, internet, or smartphone available to them, they were not able to even get their hands on their patient portals.

White patients did tend to have easier access to technology, making it easier for them to get to their patient portals.

Other studies have shown similar trends. Experts from athenaResearch, for example, recently found that patients newly aging into Medicare are increasingly enthusiastic about patient portal adoption.

AthenaResearch’s vice president Josh Gray, along with its manager David Clain, hypothesize that this is because patients who are between 60 and 65 are more native technology users.

“If you look at patients in their 60s and up to 65, a lot of those patients are still in the workforce. They’ve had iPhones for 10 years since they were in their mid-50s,” Clain explained. “So I think that a lot of those patients are comfortable with using technology, and a patient portal may be a new approach to working with their physicians in a way that they didn’t do before, but they’re comfortable getting online, they’re comfortable using their phones to get on a portal, or using a computer.”

Gordon and Hornbrook say that these findings perhaps show that providers need to concentrate more on older patient populations. Because younger patients are more predisposed to using technology and thus patient portals, it is up to providers and industry experts to determine how to reach those who do not use technology and may not necessarily want to.

“Evaluation of portal use among the population segments with lower ability/desire to use Internet-based communication will require that researchers pay attention to population sampling and post-stratification weighting of respondent data in the absence of data on the full population, such as we employed for our comparisons of account registration and utilization of patient portal features,” the pair wrote.

The results of this study show that providers need to look more closely at different populations within the overarching senior patient population, like older patients or Hispanic, black, or Filipino patients. However, Gordon and Hornbrook say that more research will need to be done to develop better patient engagement approaches.

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