Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
J Gen Intern Med. 2011 Oct;26(10):1112-6. doi: 10.1007/s11606-011-1728-3. Epub 2011 May 3.
With emphasis on the meaningful use of electronic health records, patient portals are likely to become increasingly important. Little is known about patient enrollment in, and use of, patient portals after explicit invitation from providers.
To examine enrollment in, and use of, an electronic patient portal by race/ethnicity, gender and age.
Observational, cross sectional study.
Patients with attending physicians seen at one urban, academic primary care practice between May 2008 and October 2009 who received electronic orders inviting their participation in an electronic patient portal.
(a) Enrollment in the patient portal, (b) Solicitation of provider advice among enrollees, (c) Requests for medication refills among enrollees.
Overall, 69% of 7,088 patients enrolled in the patient portal. All minority patients were significantly less likely to enroll than whites: 55% blacks, 64% Latinos and 66% Asians compared with 74% whites (chi-square p < 0.05 for all pairwise comparisons). These disparities persisted in adjusted analyses, although differences for Asians were no longer significant. In addition, the oldest patients were less likely to enroll than the youngest (adjusted OR 0.79, 95% CI 0.65-0.97). Although there were no racial/ethnic disparities in use of the patient portal among enrollees, we found differences by age and gender. The youngest patients were significantly less likely to solicit provider advice or request medication refills than any other age group in unadjusted and adjusted analyses. Similarly, male patients were less likely to solicit provider advice than women in all analyses.
Large racial/ethnic disparities were seen in enrollment in our patient portal. Among enrollees, use of the portal was similar by race/ethnicity, but not by age or gender. Future efforts to expand use of the patient portal need to address potential mechanisms for these disparities to ensure this technology is accessible to diverse patient populations.
随着电子健康记录的意义重大，患者门户可能会变得越来越重要。关于在提供者明确邀请后，患者注册和使用患者门户的情况知之甚少。
按种族/民族、性别和年龄检查电子患者门户的注册和使用情况。
观察性、横断面研究。
2008 年 5 月至 2009 年 10 月间在一个城市学术初级保健诊所就诊的有主治医生的患者，他们收到了电子医嘱，邀请他们参与电子患者门户。
(a)患者门户的注册，(b)注册用户向提供者征求意见，(c)注册用户要求药物续开。
总体而言，7088 名患者中有 69%注册了患者门户。所有少数族裔患者的注册率明显低于白人：黑人 55%，拉丁裔 64%，亚洲人 66%，而白人 74%（所有两两比较的卡方 p 值均<0.05）。在调整分析中，这些差异仍然存在，尽管亚洲人的差异不再显著。此外，最年长的患者比最年轻的患者更不可能注册（调整后的 OR 0.79，95%CI 0.65-0.97）。尽管在注册用户中，患者门户的使用没有种族/民族差异，但我们发现年龄和性别存在差异。在未调整和调整分析中，最年轻的患者在征求提供者建议或要求药物续开方面的可能性均明显低于任何其他年龄组。同样，在所有分析中，男性患者征求提供者建议的可能性均低于女性。
我们的患者门户在注册方面存在很大的种族/民族差异。在注册用户中，门户的使用情况因种族/民族而异，但与年龄或性别无关。未来扩大患者门户使用的努力需要解决这些差异的潜在机制，以确保这项技术能为不同患者群体所使用。
