Dec. 5, 2018
Dive
Brief:
- Patient
portals can be important tools for increasing patient interaction with
personal health data and fostering communication with providers, but only
if patients are willing to use them. In a sample of U.S. adults, 63%
reported not using a portal in the past year, a new Health Affairs study shows.
- Researchers
from the University of Michigan School of Public Health and University of
Wisconsin-Milwaukee analyzed data on 2,325 insured respondents to the 2017
Health Information National Trends Survey to understand who nonusers are
and why they don't use portals.
- Nonusers tended to be male, on
Medicaid, not have a regular doctor and have less higher education than
portal users. Those trends also carried over to who was likely to be
offered portal access, with fewer nonwhites reporting being given the
option.
Dive
Insight:
Patient
portals are a frequent source of frustration for patients and providers. In a
recent Ernst & Young survey,
just 39% of doctors said they use patient portals. Still, a 2017 West survey found
three-fourths of patients with chronic conditions want regular contact with
their doctor so they can hear quickly if anything looks amiss.
A
recent Journal of American Medical Informatics Association study suggested
that teaching patients how
to access a patient portal and the portal's role in their post-discharge care
increases engagement both during and after hospitalization while improving the
patient experience.
Reasons
for not using a portal included lack of internet access, no online record, the
desire to speak directly to providers and privacy concerns. Patients ages 40
and up and non-Hispanics of other races were more likely to cite privacy and
security concerns than younger and non-Hispanic white patients. Meanwhile,
Medicare and Medicaid patients were more likely to want to speak with their
caregiver rather than get information via portal.
The
researchers point to several policy implications of the study. While the CMS
meaningful use program requires providers to give 80% of their patients access
to a certified portal, the incentives don't focus on who is using them.
Realigning incentives to encourage use by disadvantaged patients could reduce
health disparities, they say.
Providers
also need to step up their game to educate patients about technologies and ease
privacy concerns.
"New
communication practices to facilitate patient engagement work best in the
context of engaged providers and trusting provider-patient relationships,"
the researchers write. "Careful monitoring of who is and who is not using
new technologies, and why, and designing technologies to address patients'
needs, will help ensure that such innovations do not exacerbate disparities but
rather lead to improvements for all."
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