JMIR Publications

ABSTRACT

Background:

Acute care portals – less studied than ambulatory – may also be important to help with patient experience and engagement throughout the care continuum, especially for care transitions. However, patient portal disparities exist and may lead to differences in access or outcomes. As such, it is important to study upstream factors in a typical hospital workflow that could lead to those disparities in safety net settings.

Objective:

The objective of this study was to evaluate sociodemographic characteristics associated with interest in an online portal and reasons for no interest.

Methods:

Nurses assessed interest in an online patient portal (yes/no) as part of the admission nursing assessment among patients at an academic urban safety net hospital and recorded responses in the electronic health record (EHR), including reasons for no interest. We extracted patient responses from the EHR.

Results:

Among 23995 hospitalizations over a two year period, 31% reported interest in an online portal. Interest was lower in older, non-White, non-English speaking and homeless patients. Reasons for “no” interest included: “not interested/other reason” (42%); "no ability to use/access computers/internet” (30%); “doesn’t speak English” (11%); or “physically or mentally unable” (9%).

Conclusions:

In a safety net system, patient interest in an online portal—a required step prior to enrollment—is low with significant disparities by sociodemographic characteristics. In order to avoid worsening the digital divide, new strategies are needed embedded within routine workflows to engage vulnerable safety net patients in the use of online health technologies.