Most healthcare systems have instituted patient portals for patient access to their specific healthcare data. The theory is patients – or in the language of business, customers – want to have access to their own information to inform better health decision-making. Is there evidence that patient portals are used? Or, in fact do they make a difference in patient approaches to healthcare decision-making?
A report by Reuters on January 3, 2019 helps to inform some answers to the questions. The Reuter’s report is based on a Health Affairs article published in December of 2018 and suggests portals are not frequently used by patients. The data for this report came from a nationally representative survey of more than 2,000 patients and showed that nearly two-thirds of insured patients had not used an online medical portal in the preceding year, while sixty percent had not been offered access to a portal.
The nonuse of portals correlated with age over 65 years, unemployed status, rural address, Medicaid as primary payer, high school or lower educational level and lack of a regular physician. Similar characteristics, as well as being non-white, were seen among people who said they weren’t offered access to a patient portal. When probing the reasons for non-use of a portal the study participants reported difficulty with internet access, no knowledge of an online medical record, preference to speak directly with their physician and concerns over privacy.
Thus, the senior Health Affairs author, Denise Anthony of the University of Michigan, raised concerns with Reuters that portals may be amplifying unequal access to health information. As a physician who is closely involved in providing access to internet-accessible personal health information, my assessment is that patient portals are often presented in a health system-centric manner, thus, leaving patients without the framing tools to fully understand the data to guide health decision making. The concerns over inequality raised by Anthony and colleagues, needs to further examine the inequality that is created between health literate portal users and those with necessary skills to use their information effectively. Access to the data is an easy step to solve, using the data effectively is more difficult. We have a solution at Curadux.