Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 24, 2020
Date Accepted: Aug 16, 2020
Patient portal barriers and group differences: A cross-sectional, national survey
ABSTRACT
Background:
Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and healthcare settings, limiting generalizability.
Objective:
This study has two objectives: 1) to assess the prevalence of barriers to patient portal adoption among non-adopters; and 2) to examine the association between non-adopter characteristics and reported barriers in a nationally representative sample.
Methods:
Data from this study were obtained from the 2019 Health Information National Trend Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression to examine which demographics were associated with reported barriers.
Results:
The sample included 4,815 individuals (227,463,350 weighted population); 58.7% had not adopted a patient portal. The three most common barriers to adoption were preference for in-person communication (64%), no perceived need for the portal (49%), and lack of comfort with computers (26%). While men had significantly lower odds of indicating a preference for in-person communication (OR: 0.75; 95% CI: 0.60-0.94, p = 0.012), older adults had significantly higher odds of reporting a preference for in-person communication (OR: 1.01; 95% CI: 1.00-1.02, p = 0.000). Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR: 1.59; 95% CI: 1.24-2.05, p = 0.000) compared to non-Hispanic individuals. Older individuals (OR: 1.05; 95% CI: 1.04-1.06, p = 0.000) and individuals with a chronic condition (OR: 1.42; 95% CI: 1.08-1.86, p = 0.012) had significantly higher odds of indicating that they were uncomfortable with a computer.
Conclusions:
The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed tailor implementation approaches based on the patient characteristics that are associated with each barrier. Clinical Trial: Not applicable
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