JMIR Publications

ABSTRACT

Background:

Kidney and liver transplant recipients must manage a complex care regimen after kidney transplant. Although the use of web-based patient portals is known to improve patient-provider communication and health outcomes in chronic disease populations by helping patients manage post-transplant care, disparities in access to and use of portals have been reported. Little is known about portal usage and disparities among kidney and liver transplant recipients.

Objective:

The aim of this study was to examine patient demographic, clinical, and socioeconomic characteristics associated with portal usage among kidney and liver transplant recipients.

Methods:

The study included all adult kidney and liver transplant recipients (n=710) at a large academic transplant center in the Southeastern United States between March 2014 and November 2016. Electronic health record data was linked with Cerner portal usage data. Patient portal use was defined as any portal activity (vs. no activity) recorded in the Cerner web-based portal, including viewing of health records, lab results, medication lists, and the use of secure messaging. Multivariable log-binomial regression was used to determine the patient demographic, clinical, and socioeconomic characteristics associated with portal usage, stratified by organ.

Results:

Among 710 transplant recipients (n=455 kidney, n=255 liver), 55% of kidney recipients and 48% of liver recipients used the patient portal. Black patients were less likely to use the portal vs. white patients among both kidney (57% black vs. 74% white) and liver (28% black vs. 55% white) transplant recipients. In adjusted multivariable analyses, kidney transplant recipients were more likely to use the portal if they had higher education; among liver recipients, patients who were white vs. black race, and had higher education were more likely to use the portal.

Conclusions:

Patient portals have the potential to benefit transplant recipients as a tool for health management, but racial and socioeconomic disparities should be considered prior to widespread implementation. Transplant centers should include portal training and support to all patients to encourage use given its potential to improve outcomes.