Barriers to Patient Portal Access and Use: Evidence from the Health Information National Trends Survey

• Authors: Sherine El-Toukhy, National Institute on Minority Health and Health Disparities, NIH; Alejandra Méndez, National Institute on Minority Health and Health Disparities, NIH; Shavonne Collins, Emory University; Eliseo J Pérez-Stable, National Institute on Minority Health and Health Disparities, NIH
• Journal Title: Journal of the American Board of Family Medicine
• Volume: Volume 33, Number 6
• Publisher: HighWire | 2020-11-01, Pages 953-968
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.3122/jabfm.2020.06.190402
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: electronic health records; health disparities; ehealth; health information technology; patient portals

Abstract

Background: Patient access to their medical records, through patient portals, facilitates information exchange and provision of quality healthcare. Understanding factors that characterize patients with limited access to and use of patient portals is needed. Methods: Data were from the 2017-18 Health Information National Trends Survey 5, cycles 1 and 2, a nationally representative survey of US adults ≥18 years old (N=6,789). Weighted multivariate logistic regressions modeled the associations between patient characteristics and access to, facilitators of use, and use of patient portals and their functions. Results: Individuals without (vs. with) a regular doctor (AOR 0.4, CI 0.3-0.5) or health insurance (AOR 0.4, CI 0.2-0.7), those with high school (AOR 0.4, CI 0.3-0.5) or with vocational/some college (AOR 0.5, CI 04.-0.7) education (vs. college/ postgraduate), or those with limited English proficiency (vs. those who speak English very well) (AOR 0.7, CI 0.5-0.9) were less likely to report accessing their personal medical records. Women (vs. men) were more likely to report accessing their medical records (AOR 1.5, CI 1.2-1.8). Similar patterns were found for patient portals access and facilitators of use. Less consistent associations emerged between patient characteristics and use of patient portal functionalities. Conclusions: Patient portals access and use are low. Having a primary care clinician, patient’s educational attainment, and being a woman were factors associated with patient portal access and use, but not race/ethnicity. Once access was achieved, use of patient portal functionalities was generally uniform across demographic segments. Facilitating patient portal access and use among all patient populations is warranted.