Arcury Thomas A, Quandt Sara A, Sandberg Joanne C, Miller David P, Latulipe Celine, Leng Xiaoyan, Talton Jenifer W, Melius Kathryn P, Smith Alden, Bertoni Alain G
Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States.
Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States.
JMIR Med Inform. 2017 Nov 14;5(4):e47. doi: 10.2196/medinform.8026.
Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization.
The primary objective for this analysis was to use a conceptual framework to determine potentially modifiable factors affecting patient portal utilization by older adults (aged 55 years and older) who receive care at clinics that serve low income and ethnically diverse communities. The secondary objective was to delineate how patient portal utilization is associated with perceived usefulness and usability.
Patients from one urban and two rural clinics serving low income patients were recruited and completed interviewer-administered questionnaires on patient portal utilization.
A total of 200 ethnically diverse patients completed questionnaires, of which 41 (20.5%) patients reported utilizing portals. Education, social support, and frequent Internet utilization improve the odds of patient portal utilization; receiving health care at a rural clinic decreases the odds of portal utilization.
Leverage points to address disparities in patient portal utilization include providing training for older adults in patient portal utilization, involving spouses or other care partners in this training, and making information technology access available at public places in rural and urban communities.
患者门户网站若得到使用，可改善患者与医疗服务提供者之间的沟通，为患者提供更多获取健康信息的途径，并有助于改善患者的决策。由于关于促进和限制患者门户网站使用因素的研究并非基于概念，因此未指出可提高使用率的杠杆点。
本分析的主要目的是使用一个概念框架来确定影响在为低收入和种族多样化社区提供服务的诊所接受治疗的老年人（55岁及以上）使用患者门户网站的潜在可改变因素。次要目的是描述患者门户网站的使用与感知有用性和可用性之间的关联。
招募了来自一家城市诊所和两家农村诊所的低收入患者，并完成了由访谈员管理的关于患者门户网站使用情况的问卷。
共有200名不同种族的患者完成了问卷，其中41名（20.5%）患者报告使用了门户网站。教育程度、社会支持和频繁使用互联网可提高患者使用门户网站的几率；在农村诊所接受医疗服务会降低使用门户网站的几率。
解决患者门户网站使用差异的杠杆点包括为老年人提供患者门户网站使用培训，让配偶或其他护理伙伴参与该培训，以及在农村和城市社区的公共场所提供信息技术接入。
