- Patient portal adoption rates are lagging among older patient populations, revealed a survey conducted by the University of Michigan Institute for Healthcare Policy and Innovation. The survey of just over 2,000 patients ages 50 to 80 years old revealed that only half of older adult patients have signed up for a patient portal account.
Those findings highlight serious shortcomings in consumer patient portal uptake, considering most healthcare providers offer patients access to their medical records, said the survey sponsored by AARP and Michigan Medicine.
Stratified further, the survey found that 52 percent of patients just reaching retirement (ages 50-64) had adopted the portal, while 49 percent of patients 65-80 have adopted the tool.
Patients with higher education attainment or higher household incomes were more likely to have adopted the patient portal compared to their less educated or affluent peers, the survey revealed. This finding comes even as poor patients and patients with low educational attainment experience adverse medical conditions at a higher rate.
A general distrust of digital health tools and online patient-provider communication was the cause of limited patient portal uptake, the survey indicated.
Of those who did not sign up for the patient portal, 52 percent said they had security concerns about communicating medical information digitally. Fifty percent said they didn’t see a need for that level of patient health data access, while 40 percent said they simply hadn’t gotten around to setting up their accounts yet.
Furthermore, 27 percent of respondents said they did not trust that health information discussed digitally would be as accurate to a phone call or in-person conversation. Nineteen percent of patients had concerns about knowing the staff member answering a patient portal message, and 17 percent had concerns about the timeliness of a patient portal message response.
These findings underscore a potential digital health lag among some older patient populations, noted survey administrators.
“The health care system has provided patient portals as an efficient way for patients to communicate with their providers,” Sarah J. Clark, MPH, co-associated director of the poll and an associate research assistant at U-M Medical School, said in a statement. “But many older adults are uncomfortable with electronic interactions substituting for a phone call or in-person conversation.”
Despite calls for better patient engagement technology access, providers need to take these patient preferences into account when designing patient communication and outreach systems, said Preeti Malani, MD, a U-M Medical School professor.
“Many older adults still prefer telephone contact with their providers,” Malani pointed out, noting that 47 percent of poll respondents said calling was a better way to explain their request. “We hope providers, and health systems, will take these findings into consideration when designing the ways patients can interact with them.”
Patients who had adopted the patient portal had different perceptions of patient engagement technology compared to those who had not enrolled on the tool. To start, those patients were evenly split as to whether patient portal messages or phone calls yielded a faster response rate.
But even when healthcare consumers had adopted the patient portal, the patient engagement tool has not been used to its fullest potential. While 84 percent of patients who had adopted the portal said they used the tool to look at medical test results, the other functions on the patient portal went largely unused.
Only 43 percent of respondents had refilled a medication online, 37 percent had used online appointment scheduling, and only 26 percent had solicited health advice from their provider via secure messaging.
Healthcare consumers who have adopted the patient portals are also not utilizing the tool to consult with family caregivers and loved ones, despite the importance of caregivers on patient engagement and the patient experience.
Less than half (43 percent) of respondents who had adopted the patient portal said they had authorized someone else to access the portal. Third parties given patient portal access usually included spouses and partners, but in some cases also included adult children and other family caregivers.
Twenty-two percent of patients said they did not know how to authorize a third party to access the patient portal and 35 percent said they prefer to keep their own medical information entirely private.
Survey administrators noted that patient preferences are important, and if the patient portal is not what the patient perceives as convenient, that view may be unchangeable. However, as patients age into more complex health issues, it’d behoove providers to still deliver patient education about certain patient engagement technologies.
“’Convenience’ is in the eye of the beholder, and traditional methods of communication with providers still feel more comfortable, accessible, and secure for many older Americans,” said Alison Bryant, PhD, senior vice president of research for AARP. “There are great opportunities for us to empower both patients and their caregivers through these technologies, however.”
Despite popular advice, there is little evidence that older patient populations adopt the patient portal at lower rates than other patients. An ONC data brief from April 2018 revealed that patient portal adoption rates have reached 52 percent among all adult patients over age 18, just one percentage point higher than the older population surveyed in the U-M report.
Most experts assert that older patients being resistant to patient portal adoption due to their age is a common misconception. In fact, older patient populations are increasingly poised to adopt the patient portal because they have adopted other forms of technology into their everyday lives – computers, tablets, and smartphones are not uncommon for the over 60 crowd.
Instead, it is essential for healthcare organizations and technology developers to address the concerns that keep all patients from adopting the portal, including limited tool usability and security concerns.