Disparities in Enrollment and Use of an Electronic Patient Portal

Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics

“…These findings comport with earlier studies in non-nephrology settings (32)(33)(34)(35)(36). While the increase in portal adoption across groups in more recent years suggests progress, the continued differences in portal adoption among nephrology patients are disquieting because socioeconomic and racial disparities in CKD outcomes are well documented (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11).…”

“…Covariates for adjustment were chosen according to clinical significance and possible effect on portal adoption (1,(3)(4)(5)(6)(7)(8)10,11,(13)(14)(15)29,31,33,34,36,(54)(55)(56)(57)(58)(59)(60)(61)(62)(63). Sociodemographic variables were age, sex, race, marital status, insurance status, neighborhood median household income, tobacco use, and follow-up duration.…”

“…We sought to address this gap by examining portal use, including secular trends, in universityaffiliated general nephrology clinics. Given previous literature indicating that underserved groups are less likely to use EHR portals (32)(33)(34)(35)(36), we hypothesized that race, neighborhood median household income, and insurance status would be associated with portal use and of particular concern in view of documented CKD disparities in these groups (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). In addition, we believed that BP control, a key modifiable outcome that affects CKD progression, would depend on patient adherence, self-monitoring, and patient-provider communication.…”

The Association Between Personal Health Record Use and Diabetes Quality Measures

“…As demonstrated in previous studies, 7,8 we found significant demographic differences in PHR users and non-users, including such factors as lower age and higher incomes. Given these differences, it was not surprising to find better unadjusted diabetes quality measure profiles in PHR users.…”

Health Information Technology and Disparities in Quality of Care

“…4 In this issue of JGIM, two studies contribute to the growing evidence base around disparities in the use of health information technology. 5,6 Goel et al studied a single group practice affiliated with an academic medical center, and analyzed use of a patient portal that is directly integrated within a commercial electronic health record. In this setting, providers offer enrollment to their patients, and these offers were tracked via the placement of electronic orders.…”