Patient Portal Use in Pediatric Urology—Is it Meaningful Use for Everyone?. Issue 4 (July 2018)

• Record Type: Journal Article
• Authors: Bush, Ruth A.; Richardson, Andrew C.; Cardona‐Grau, Diana; Din, Hena; Kuelbs, Cynthia L.; Chiang, George J.
• Is Part Of: Urology practice. Volume 5:Issue 4(2018)
• Publication Date: 2018-07
• Subjects: digital divide -- patient portals -- electronic health records -- meaningful use -- patient participation
• DOI: 10.1016/j.urpr.2017.05.002
• Languages: English
• ISSNs: 2352-0779

Abstract

Abstract : Introduction : The Affordable Care Act promotes multiple directives for meaningful use of the electronic health record, such as patient/provider portals, to increase patient engagement. Although portal use is common within adult health care, little information exists regarding pediatric portal use. We examined pediatric urology patient portal enrollment and activation patterns at a tertiary pediatric hospital in Southern California by race/ethnicity, preferred language, gender and residential region. Methods : Retrospective electronic health record analysis of enrollment in patient portal from January 2010 to May 2016 among 10, 464 patients with at least 1 outpatient urology clinic visit. Differences in adoption rates were examined using logistic regression for the categories of activated (or caregiver activated), code accepted not activated, declined and activated/then deactivated. Results : Overall, 46.5% of patients/caregivers activated the portal. Primarily Spanish speaking patients were less likely to activate than English speaking patients (OR 0.25, p <0.001). Males (OR 0.89, p = 0.004); those self‐identifying racially as other (not white, Asian or black, OR 0.47, p <0.001) and Hispanic patients (OR 0.49, p <0.001) were less likely to activate. Suburban patients were up to 3 times more likely to activate portals than central urban patients depending on the region (OR 2.94, p <0.001). Multivariate logistic regression demonstrated Spanish speaking patients were 3 times less likely to activate while controlling for demographic and region variables. Conclusions : Primary language and socioeconomic factors may be significant barriers to portal adoption. Patient education to reduce these barriers may increase portal acceptance and increase meaningfulness to the portal for patients/parents and providers.