JMIR Publications

ABSTRACT

Despite the implementation of Internet patient portals into the safety net since the Affordable Care Act (ACA) of 2014, little attention has been paid to the process of engaging vulnerable patients into these portals. In fact, the portal is a health technology tool that was developed with a “mainstream, English-speaking audience” in mind. There are valid concerns that such technologies, like the patient portal, will actually exacerbate healthcare disparities, conferring “further advantages to the already advantaged.” In this paper, we describe a conceptual framework for portal engagement (awareness, registration and use) among safety net patients. We then incorporate the experiences in the Los Angeles County Department of Health Services to illustrate important contextual factors in our safety net portal plan. Finally, we discuss considerations for moving forward with health technology in the safety net, as the next version of patient portals are being developed.