George Mason University Study Finds Digital Divide and Lower than Expected Use of Patient Portals for Electronic Health Records

In a new study published in the American Journal of Health Promotion, Dr. Alicia Hong, Professor at George Mason University’s College of Health and Human Services, and colleagues examined the trends of how Americans used patient portals of electronic health records (EHR) from 2014 to 2018 using data from national surveys.

Following the Health Information Technology for Economic and Clinical Health (HITECH) Act, most hospitals and clinics have adopted EHR and given their patients access to their patient portals. This allows patients to make appointments, view and download their testing reports, and communicate with their providers via online secure messaging. The use of patient portals offers the benefits of reducing medical costs, increasing access, and improving health care quality.

Their data analysis revealed that the use of patient portals increased from 25.6% in 2014 to 30.5% in 2017, and 31.4% in 2018, much lower than anticipated. The users of patient portals were more likely to be white females with higher levels of education or income, suggesting a persistent digital divide. Meanwhile, high-speed internet access, prior experience of online communication with health care providers, and having confidence in EHR data safety were linked to more patient portal use, suggesting facilitators of patient portal use.

Dr. Hong and colleagues call for more research on the significant digital divide in the adoption of patient portal use; they also advocate for targeted intervention for people of low socio-economic status, especially the programs that would improve eHealth literacy and public confidence in data safety.

Other authors of the study include Drs. Shaohai Jiang and Piper Liping Liu of National University of Singapore.