Why Patient Portals Need to Serve All Populations

While patient portal adoption appears to be increasing, greater attention is needed to understand why underserved populations—in particular—do not access portals at the same levels as the rest of socio-demographic groups.

That's the finding of a new Vanderbilt University study of more than 2,800 patients with chronic kidney disease treated at nephrology clinics that examined patient portal use.    

The study, published in the Clinical Journal of the American Society of Nephrology, reported that 39 percent of patients accessed the patient portal.

Khaled Abdel-Kader, M.D., a nephrologist and assistant professor of medicine at Vanderbilt University, points out that one of the goals of the HITECH Act was to “bridge and mitigate” some of the disparities among underserved populations through the use of health IT. Nonetheless, according to the results of the study, African-Americans, older patients, those with lower neighborhood median household incomes, and patients with Medicare/Medicaid were all less likely to use the patient portal.

Also See: ONC Survey Finds Disparities for Some Health IT

Within nephrology, Abdel-Kader says there are well-described disparities in health in underserved communities. “We know, for instance, that there are higher risks of chronic kidney disease among African-Americans and those patients with lower socio-economic status, as well as higher rates of progression to dialysis,” he says, making the use of portals for these vulnerable populations all the more important.

One of the findings of the study was that portal use was associated with blood pressure control in patients with a diagnosis of hypertension—an important step in managing chronic kidney disease. In addition, patient portal use promoted several important actions: 87 percent of users reviewed laboratory results, 85 percent reviewed their medical information, 85 percent reviewed or altered appointments, 77 percent reviewed medications, 65 percent requested medication refills, and 31 percent requested medical advice from their renal provider.

“Future research should examine barriers to the use of e-health technologies in underserved patients with chronic kidney disease, interventions to address them, and their potential to improve outcomes,” concludes the study.

“Portals have caught on with providers because they integrate into an electronic health record and they meet Meaningful Use requirements,” comments Abdel-Kader. “But, I think the bigger question is: what do patients want? And, how do we build a tool that’s responsive to those needs?”