Susan Woods|Christopher W. Forsberg|Erin Schwartz|Kim M. Nazi|Judith H. Hibbard|Thomas K. Houston|Martha S. Gerrity
The Association of Patient Factors, Digital Access, and Online Behavior on Sustained Patient Portal Use: A Prospective Cohort of Enrolled Users
MaineHealth|VA Portland Health Care System|United States Department of Veterans Affairs|Veterans Health Administration|VA Portland Health Care System|VA Portland Health Care System|United States Department of Veterans Affairs|Veterans Health Administration|University of Oregon|Bedford VA Research Corporation|VA Portland Health Care System
electronic health records computerized workflows expand unprecedented opportunities digitally connect patients using secure portals realize value patient portals initial reach across populations need demonstrated well sustained usage timethe study aim identify patient factors associated shortterm longterm portal usage patients registered access portal functionswe prospectively followed cohort patients large department veterans affairs va health care facility recently completed identity proofing use va patient portal information collected baseline encompassed patient factors potentially associated portal usage including demographics internet access use health literacy patient activation selfreported health conditions primary outcome frequency portal logins 6month 18month time intervals study enrollmenta total 270 study participants followed prospectively almost participants 260268 970 reported going online typically home 248268 925 6 months 841 227270 participants visited portal variation usage across demographic healthrelated subgroups significant differences portal logins age gender education marital status raceethnicity distance va facility patient activation measure significantly higher portal usage seen among participants using highspeed broadband home greater selfreported ability using internet routinely going online 18 months 91 participants logged portal significant associations found usage demographics health status patient activation examining portal activity 6 18 months patients infrequent high portal users remained categories respectivelyshortterm longterm portal usage associated broadband home high selfrated ability using internet overall online behavior digital inclusion ready access internet digital skills appears social determinant patient exposure portal services