Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 14, 2018
Open Peer Review Period: Dec 17, 2018 - Feb 11, 2019
Date Accepted: Jul 5, 2019
(closed for review but you can still tweet)
Patient portal: how does it change our health behaviors and outcomes? - a single case study at Penn Medicine
ABSTRACT
Background:
Patient portals are frequently deployed in modern healthcare systems as an engagement and communication tool. An increased focus on the potential value of these communication channels to improve health outcomes is warranted.
Objective:
This paper aims to quantify the impacts of portal use on patients’ preventive health behavior and chronic health outcomes.
Methods:
We conducted a retrospective, observational cohort study of 10,000 patients ≥50 years of age treated at the University of Pennsylvania Health System (UPHS) from September 1st, 2014 to October 31st, 2016. The data were sourced from the UPHS electronic health records (EHR). We investigated the association between patient portal use and patients’ preventive health behaviors or chronic health outcomes, controlling for confounders using a novel cardinality matching approach based on propensity scoring and a subsequent bootstrapping method to estimate the variance of association estimates.
Results:
Patient-level characteristics differed substantially between portal users (U), comprising ~59% of the cohort, and non-users (NU). On average, users were more likely to be younger (U: 63.5 years; NU: 66.0 years), white (U: 72.8%, NU: 53.3%), have commercial insurance (U: 61.2%, NU: 39.8%), and have higher annual incomes (U: $74,172/yr, NU: $62,940/yr). Even after adjusting for these potential confounders, patient portal use had positive and clinically meaningful impacts on patients’ preventive health behaviors, but not on chronic health outcomes.
Conclusions:
This paper contributes to the understanding of the impacts of patient portal use on health outcomes, and is the first study identifying a meaningful subgroup of patients’ health outcomes that improved with portal use. These findings may encourage providers to promote portal use to improve patients’ preventive health behaviors. Clinical Trial: NA
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.