More on Patient Engagement

Age, race disparities found in the use of hospital patient portals

Patients age 60 and over used the portal less than younger patients, and African Americans used the portal less than white patients.

Jeff Lagasse, Associate Editor

Removing the barriers of access to technology does not close the digital divide for African American and older patients, according to new research from The Ohio State University College of Medicine.

As part of a larger examination of patient portal use, researchers looked at the use of patient portals while people are admitted in the hospital. Over a one-year period, they found patients age 60 and over used the portal less than patients ages 18 to 29, and African American patients used the portal less than white patients.


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Patient portals, and other types of patient-facing technology, are meant to engage patients more in their healthcare by facilitating better communication with the care team. They allow patients to access things like test results, progress notes and other information that's stored in their medical records.

They're also meant, in part, to facilitate brand loyalty. Patients are now consumers, and increasingly demand digital ease and convenience to be a major part of their care experience -- particularly younger patients who have grown up with technology.

Patients enrolled in the study used a hospital-provided tablet with a password-protected patient portal application they could access; they were not prompted to use the patient portal by the study team. To measure portal usage, researchers looked at the total number of tasks completed during the hospital stay, such as logging into the application, sending messages to the care team, viewing test results, ordering meals and accessing tutorials.

The 60 to 69 age group used the inpatient portal 45% less than the 18 to 29 age group, and the 70 and over age group used the inpatient portal 36% less than the 18 to 29 age group. African American patients used the portal 40 percent less than white patients.

Older patients used the tutorial feature more often than their younger counterparts, suggesting the former may abstain from using the application due to limited knowledge of how to use it -- something that could potentially be remedied by training resources.

The disparity between African American and white patients was more of a mystery, suggesting differences in use were more nuanced than a simple access issue. Researchers signaled their intent to explore that issue further.


Patient portals have evolved over time, transitioning from simple logins to a health system's data to mobile apps that provide access to those systems.

Several companies have tried to make a run at creating a portal that establishes an industry standard, a model for all others to follow. But those efforts, from giants like Google and Apple, have met with only varying levels of success.

Stephen Dart, senior director of product management at AdvancedMD, told Healthcare Finance News last year that one of the issues is the lack of a universal privacy standard. In some states, the default is that a patient's data is shareable and the patient has to actively opt out; in other states, that dynamic is reversed.

Twitter: @JELagasse

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