Patient portals provide a simple, fast way to connect patients with cancer to their providers. Portals facilitate open communication, tracking of patient-reported outcome measures, clinical notes and referrals, remote monitoring, and assistance getting upfront care.
However, use of patient portals remains spotty with groups lacking reliable Internet access, mobile devices or computers, or health literacy being less likely to benefit. A team of researchers led by Joan M. Griffin, PhD, from the Mayo Clinic in Rochester, MN, published the results of study looking at patient portal use in cancer populations in the Journal of the National Cancer Institute (JNCI).
There were 28,942 eligible patients with cancer across the IMPACT research consortium which included eight healthcare systems across the country. The researchers wanted to identify which participants were more likely to access their patient portal at all, and which participants were more likely to engage for a longer period. They looked at participants’ electronic health records (EHRs) a year prior to the participant enrolling in the consortium research study. Persistence in portal use was assessed based on how many weeks in a 35-week period the participants logged into their portal.
Overall, 35% of participants never accessed their patient portal in the examined period. Characteristics associated with any patient portal use during the period were younger age, female gender, White race, non-Hispanic ethnicity, being employed, living in a metropolitan area, and living in an area with broadband Internet. Participants who had more clinical encounters also used the patient portal more frequently.
Participants who persistently used the patient portal (25% of the sample) were more likely to use both mobile and web-based modes of access, be middle aged, and have more clinical encounters. Importantly, other participant characteristics that were associated with never using the portal were not significantly associated with persistent use. This suggests that once participants can get started with their portal, they are likely to continue using it.
The researchers summarize these findings by saying that both structural and patient level factors impact patient portal use. Clinicians may need to provide outreach to people less likely to engage with their portal to ensure they are familiar with the procedures and features of the portal. This is particularly true for older patients, those without a partner, and those from groups considered to be a racial or ethnic minority. If these patients can see that portal, be allayed of concerns regarding privacy and security, and see the potential benefits for their health and communication, then they may be more likely to engage in portal use in the long-term.
Groups of cancer patients who have limited access to broadband internet or electronic devices on which patient portal depends require special attention. As policy makers and developers continue to expand access, cancer centers must provide alternative modes for implementing interventions and patient access measures such as paper options, interactive voice options, and tablets within the clinical setting.
Griffin, J. M., Kroner, B. L., Wong, S. L., Preiss, L., Smith, A. W., Cheville, A. L., … & Yanez, B. (2023). Disparities in electronic health record portal access and use among patients with cancer. JNCI: Journal of the National Cancer Institute, djad225.