Department of Pediatrics and of Public Health, Weill Cornell Medical College, New York, NY 10065, USA.
J Gen Intern Med. 2011 Oct;26(10):1117-23. doi: 10.1007/s11606-011-1749-y. Epub 2011 Jun 7.
Electronic patient portals give patients access to information from their electronic health record and the ability to message their providers. These tools are becoming more widely used and are expected to promote patient engagement with health care.
To quantify portal usage and explore potential differences in adoption and use according to patients' socioeconomic and clinical characteristics in a network of federally qualified health centers serving New York City and neighboring counties.
Retrospective analysis of data from portal and electronic health records.
74,368 adult patients seen between April 2008 and April 2010.
Odds of receiving an access code to the portal, activating the account, and using the portal more than once
Over the 2 years of the study, 16% of patients (n = 11,903) received an access code. Of these, 60% (n = 7138) activated the account, and 49% (n = 5791) used the account two or more times. Patients with chronic conditions were more likely to receive an access code and to become repeat users. In addition, the odds of receiving an access code were significantly higher for whites, women, younger patients, English speakers, and the insured. The odds of repeat portal use, among those with activated accounts, increased with white race, English language, and private insurance or Medicaid compared to no insurance. Racial disparities were small but persisted in models that controlled for language, insurance, and health status.
We found good early rates of adoption and use of an electronic patient portal during the first 2 years of its deployment among a predominantly low-income population, especially among patients with chronic diseases. Disparities in access to and usage of the portal were evident but were smaller than those reported recently in other populations. Continued efforts will be needed to ensure that portals are usable for and used by disadvantaged groups so that all patients benefit equally from these technologies.
电子患者门户使患者能够访问其电子健康记录中的信息，并与医疗服务提供者进行信息交流。这些工具的使用越来越广泛，预计将促进患者参与医疗保健。
在为纽约市及其周边县提供服务的一个联邦合格医疗中心网络中，量化患者使用门户的情况，并根据患者的社会经济和临床特征，探索采用和使用电子患者门户的潜在差异。
对来自门户和电子健康记录的数据进行回顾性分析。
2008 年 4 月至 2010 年 4 月间就诊的 74368 名成年患者。
获得门户访问码、激活账户和多次使用门户的几率。
在研究的 2 年期间，有 16%的患者（n=11903）收到了访问码。在这些患者中，有 60%（n=7138）激活了账户，有 49%（n=5791）两次或以上使用了账户。患有慢性病的患者更有可能收到访问码并成为重复使用者。此外，白人、女性、年轻患者、英语使用者和有保险的患者获得访问码的几率明显更高。在已激活账户的患者中，与没有保险的患者相比，使用门户的几率随着白种人、英语和私人保险或医疗补助的增加而增加。在控制语言、保险和健康状况后，种族差异仍然存在，但有所缩小。
我们发现，在电子患者门户部署的头 2 年中，在一个以低收入人群为主的人群中，该门户的采用和使用情况良好，尤其是在患有慢性病的患者中。虽然在获得和使用门户方面存在差异，但与最近在其他人群中报告的差异相比，这些差异较小。需要继续努力，确保门户可供弱势群体使用并被其使用，以便所有患者都能平等受益于这些技术。
