More at-risk patient populations are less likely to take advantage of an online portal, which can adversely impact their health compared to portal users, according to a study published this month in the Clinical Journal of the American Society of Nephrology.
The researchers, from Vanderbilt University and elsewhere, wanted to examine portal trends and blood pressure control of portal users. They reviewed portal use of 2,803 nephrology patients who were seen at four university-affiliated nephrology offices between Jan. 1, 2010, and Dec. 31, 2012, and who had at least one additional follow-up visit before June 30, 2013.
They found that 39 percent of the patients accessed the portal. The most common uses were to access lab results (more than 87 percent); review medical information (85 percent) and review or change appointments (77 percent). Thirty-one percent used the portal to request medical advice from their renal provider.
However, the researchers found large disparities in the types of patients who accessed the portal:
- Medicaid patients were 47 percent less likely than commercially insured patients to use the portal
- African Americans were 50 percent less likely than non-African Americans
- 80 year olds were 71 percent less likely than 40 year olds
- Patients with lower household incomes were less likely to access the portal
In an accompanying editorial, Mallika Mendu M.D., from Brigham and Women's Hospital and her colleagues noted that "the study shows that portals could perversely widen existing disparities in care by advantaging those who are already at an advantage, while not helping the disadvantaged," according to an announcement on the study.
Other research has found that portal use varies by patient population, which can cause disparities and affect health care down the road. Many have blamed inadequate portal design for hindering portal use in general.