Researchers have found that people who register and use their healthcare provider’s online portal differ in certain key features from those who do not use patient portals.
According to new research led by Naheed Ahmed, PhD, MA, MPH, of the NYU Grossman School of Medicine, “Our findings suggest that access to healthcare, along with ongoing patient health needs, influence the use of patient portal platforms. Health insurance and establishing a relationship with a primary care provider (PCP) appear to be key factors in creating a patient portal account.
Online patient portals have many benefits, including increased engagement in care and better health outcomes. Yet most Americans do not use their healthcare provider’s patient portal or register to create an account. The low rate of portal use is not simply explained by patient preferences or lack of internet access.
To investigate factors influencing health care portal use, Drs. Ahmed and his colleagues conducted an online survey using Amazon’s Mechanical Turk crowdsourcing platform. Participants answered questions about whether and how they used the online patient portal to connect with health care providers.
The researchers used a technique called latent class analysis to identify underlying factors influencing patient portal use, adjusting for other characteristics. The analysis included survey responses from 489 participants.
Initial analysis showed some qualitative differences between participants who used and did not use online portals. Users of the online portal were more likely to live in urban areas and have a higher level of education. Among non-users, lack of awareness and technical issues were the main reasons for not having an account.
Insurance and ongoing health needs are “key determinants” of portal use
Patient portal users were much more likely to have a primary health care provider: 82.5 percent versus 32.5 percent. They were also more likely to report some type of medical condition (comorbidity) or disability.
In the latent class analysis, all these characteristics were relevant to identify groups of participants according to patient portal use. After adjusting for other factors, respondents with a primary care provider were about five times more likely to have created a patient portal account (odds ratio 5.48). In contrast, participants without health insurance were much less likely to have a patient portal account (odds ratio 0.17).
Respondents with a disability or comorbidity were more likely to have an account (odds ratio 1.72 for each). This finding can be explained by the fact that patients with chronic conditions have more frequent doctor visits and are therefore more inclined to use the patient portal to stay in touch with their healthcare team.
Users of patient portals had higher scores for self-efficacy (confidence in managing health problems) and positive attitudes towards media and technology. Non-users of the portal had surprisingly higher health literacy scores.
The findings “reflect the relative importance of patients having health insurance and ongoing health needs as key determinants of patient portal use,” wrote Dr. Ahmed and his colleagues. Establishing a relationship with a PCP “can be an important help for patients to create a patient portal account and stay current and engaged with their health, including communicating with their healthcare team.”
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