Erinma P. Ukoha|Joe Feinglass|Lynn M. Yee
Disparities in Electronic Patient Portal Use in Prenatal Care: Retrospective Cohort Study
University of California, San Francisco|Northwestern University|Northwestern University
electronic patient portals websites provide individuals access personal health records allow engage secure webbased platform portals becoming increasingly popular contemporary health care systems patient portal use found beneficial multiple specialties especially management chronic disease however disparities identified portal use racial ethnic minorities individuals lower socioeconomic status shown less likely enroll use patient portals nonhispanic white persons individuals higher socioeconomic status electronic patient portal use childbearing women well studied data portal use pregnancy limitedthis study aimed quantify use electronic patient portal pregnancy examine whether disparities related patients demographics clinical characteristics existthis retrospective cohort study women received prenatal care academic medical center 2014 2016 clinical records reviewed portal use patient data patients considered enrolled portal account time delivery enrollees compared nonenrollees enrollees categorized based number secure messages sent pregnancy active 1 inactive 0 users bivariable chisquare multivariable poisson regression models used calculate incidence rate ratio portal enrollment enrolled active use based patients characteristicsof 3450 women eligible inclusion 2530 7333 enrolled portal enrollees 7209 18242530 active users difference portal enrollment maternal race ethnicity multivariable models women public insurance adjusted incidence rate ratio airr 060 95 ci 049084 late enrollment prenatal care airr 078 95 ci 069089 second trimester airr 050 95 ci 039064 third trimester highrisk pregnancies airr 082 95 ci 075089 significantly less likely enroll conversely nulliparity airr 110 95 ci 102120 8 prescription medications prenatal care initiation airr 119 95 ci 106132 associated greater likelihood enrollment among portal enrollees factor significantly associated active portal use ie secure messaging nulliparity airr 111 95 ci 101123among obstetric population multiple clinical socioeconomic factors associated electronic portal enrollment subsequent active use portals become integrated tools promote health efforts made ensure already vulnerable populations disadvantaged regard electronicbased care