Schultz Corinna L, McCahan Suzanne M, Lewis Amanda M, Bunnell H Timothy, Alderfer Melissa A
Nemours Center for Cancer and Blood Disorders, Nemours Children's Hospital, Wilmington, Delaware, USA.
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Pediatr Blood Cancer. 2021 Dec;68(12):e29373. doi: 10.1002/pbc.29373. Epub 2021 Sep 28.
Financial and regulatory incentives have encouraged and increased the availability of online patient portals that provide caregivers access to their child's electronic health records (EHR). Such access is believed to promote better engagement and outcomes of care. Little is known about the use of portals by caregivers of children with cancer. This study sought to examine whether sociodemographic and clinical care variables are associated with portal activation in a pediatric oncology sample.
Sociodemographic and clinical characteristics were extracted from the EHR of pediatric oncology patients treated for their first cancer in the Nemours Center for Cancer and Blood Disorders between 2012 and 2017. A Child Opportunity Index (COI) was calculated based on home zip code. Characteristics of children whose caregivers did and did not activate the portal were compared.
Sixty-six percent of caregivers activated a portal account with a peak within 90 days of diagnosis. In logistic regression, caregivers with a younger aged child, spoke English, lived closer to the hospital, lived in higher COI area, with longer treatment length, and more radiology tests had greater odds of portal activation. Those with private health insurance or White race were overrepresented among those who activated an account in univariate analysis.
The majority of caregivers of children with cancer activate portal accounts; however, differences in sociodemographic and clinical variables across those who did and did not activate accounts emerged. As portals become ubiquitous, we must understand how they are used and mitigate widening inequities caused by disparate portal use.
经济和监管激励措施鼓励并增加了在线患者门户网站的可用性，这些网站使护理人员能够访问其孩子的电子健康记录（EHR）。人们认为这种访问有助于促进更好的护理参与度和护理效果。对于癌症患儿的护理人员使用门户网站的情况知之甚少。本研究旨在调查社会人口统计学和临床护理变量是否与儿科肿瘤样本中的门户网站激活有关。
从2012年至2017年在Nemours癌症与血液疾病中心接受首次癌症治疗的儿科肿瘤患者的电子健康记录中提取社会人口统计学和临床特征。根据家庭邮政编码计算儿童机会指数（COI）。比较了护理人员激活和未激活门户网站的儿童的特征。
66%的护理人员激活了门户网站账户，在诊断后90天内达到峰值。在逻辑回归分析中，孩子年龄较小、说英语、居住距离医院较近、生活在COI较高地区、治疗时间较长且接受放射学检查较多的护理人员激活门户网站的几率更大。在单因素分析中，拥有私人健康保险或白人种族的人在激活账户的人群中占比过高。
大多数癌症患儿的护理人员激活了门户网站账户；然而，激活和未激活账户的人群在社会人口统计学和临床变量方面存在差异。随着门户网站变得无处不在，我们必须了解它们的使用方式，并减轻因门户网站使用差异导致的不平等加剧问题。
