‘Lots of big hospitals have a web portal that allows patients to log in to access their medical records, correspond with their doctor, view lab results and renew prescriptions among other digital tasks.
In fact, the median number of portal features and functions among hospitals ranked in the 2017 Internet Health Management Digital Hospital 500 is 17.
But just because a hospital or health system deploys a portal doesn’t mean those portals are widely utilized. A new study of hospital portal use by researchers from Metro Healthcare Medical Center and Case Western Reserve University suggests hospital portals aren’t more widely utilized because of a “digital divide” based on patient demographics.
Metro Healthcare and Case Western studied 243,258 patient portal visits over three years from 2012 to 2015. The researchers find a disparity of visits rates by ethnic groups. While only about one in three patients used the portal, use by white patients was slightly higher at 34.1% compared with 23.4% for African Americans and 23.8% for Hispanics.
Portal use by Medicaid patients at 26.5% was somewhat higher than for Medicare patients (23.4%) and distinctively more frequent than for uninsured patients.
A big factor accounting for portal use by some patient populations is lack of access to a broadband internet connection, says lead researcher Adam Perzynski, a sociologist and assistant professor of medicine at Case Western Reserve University.
“Patient portals have shown potential for increasing the quality and efficiency of healthcare, but a digital divide in home internet access has the potential to severely limit the benefits of patient portals,” says Perzynski. “Given the scale of investment in patient portals and other internet-dependent health information technologies, efforts are urgently needed to address this growing inequality.”
The researchers found that elderly, underinsured, and minority patients were less likely to live in areas where most homes have broadband internet connections. And patients in neighborhoods where broadband is scare use hospital portals less: In neighborhoods where 20% or fewer homes had a broadband connection the portal use rate was just 17.5% compared with 34.8% patient portal use where more than 80% of homes had broadband.
“Our findings indicate that three years after a patient portal rollout at a high-performing public healthcare system, an important disparity has appeared for persons without home broadband internet access,” Perzynski writes in an article for the Journal of the American Medical Informatics Association. “This evidence suggests that internet access disparities may constrain the projected benefits of patient portal use.”
A survey by the Pew Research Center released in January 2017 found that 73% of U.S. households have a broadband internet connection at home and that 77% of U.S. residents own a smartphone, which would give them access to the internet where there is a cellular connection or Wi-Fi.
The MetroHealth and Case Western researchers say the U.S. healthcare system could reduce unnecessary spending on administrative and other costs and by as much as billions of dollars over time if more than three-fourths of patients nationwide would use patient portals on a frequent basis. “Published analysis has estimated total patient portal benefits at greater than $21 billion annually” Perzynski writes. “However, that analysis assumed that 80% of healthcare patients would have access 10 years after rollout.”
Smartphones could be one way to boost patient portal use, but for now most patients still log in from their home broadband connection, the study says. “The rise in smartphone use might seem to eliminate some of the challenges presented by limits to home and neighborhood broadband access, yet recent data demonstrate that 15% of smartphone owners have no access to the internet other than their data plan,” Perzynski writes.
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