Office of the National Coordinator for Health Information Technology, Office of Technology, Washington, District of Columbia, USA.
J Am Med Inform Assoc. 2023 Jan 18;30(2):308-317. doi: 10.1093/jamia/ocac227.
The aim of this study was to identify racial and ethnic disparities in patient portal offers, access, and use and to examine the role of providers in facilitating access to electronic health information (EHI) by offering patient portals and encouraging their use.
Using nationally representative survey data from 2019 and 2020 (N = 8028), we examined disparities in patients being offered access to a portal by their provider and differences in subsequent access and use. Using multivariable models, we estimated the effect of race and ethnicity on the likelihood of being offered, accessing or using a portal. Among those offered, we examined the relationship between provider encouragement and portal access; and for those who did not access their portal, we explored reasons for nonuse.
Black and Hispanic individuals were offered and accessed patient portals at significantly lower rates than White individuals. Compared to Whites, Black and Hispanic individuals were 5.2 percentage-points less likely to be offered a portal (P < .05) and, among those offered, 7.9 percentage-points less likely to access their portal (P < .05). Black and Hispanic individuals who were offered and accessed a portal were 12 percentage-points more likely than Whites to use it to download or transmit information (P < .01). Individuals who were offered a portal and encouraged to use it were 21 percentage-points more likely to access it.
Differences in patient portal access and use are likely driven by disparities in which groups of patients reported being offered a portal.
Providers play an important role in increasing access to EHI by facilitating access to patient portals.
本研究旨在确定患者门户提供、访问和使用方面的种族和民族差异,并探讨提供者通过提供患者门户并鼓励其使用来促进电子健康信息(EHI)获取方面的作用。
使用 2019 年和 2020 年(N=8028)全国代表性调查数据,我们检查了患者被其提供者提供访问门户的机会以及随后访问和使用方面的差异。使用多变量模型,我们估计了种族和民族对提供、访问或使用门户的可能性的影响。在那些被提供的人中,我们检查了提供者鼓励与门户访问之间的关系;对于那些没有访问其门户的人,我们探讨了非使用的原因。
黑人和西班牙裔个体获得和使用患者门户的比例明显低于白人个体。与白人相比,黑人和西班牙裔个体获得门户的可能性低 5.2 个百分点(P<.05),在那些获得门户的人中,访问门户的可能性低 7.9 个百分点(P<.05)。获得并访问门户的黑人和西班牙裔个体比白人更有可能使用它下载或传输信息,比例高出 12 个百分点(P<.01)。获得门户并被鼓励使用的个体访问门户的可能性高 21 个百分点。
患者门户访问和使用方面的差异可能是由于报告获得门户的患者群体存在差异所致。
提供者通过促进患者门户的访问,在增加 EHI 访问方面发挥着重要作用。