JMIR Publications

ABSTRACT

Background:

In the abnormal circumstances caused by the COVID-19 pandemic, patient portals have supported patient empowerment and engagement by providing patients with access to their healthcare documents and medical information. However, the potential benefits of patient portals cannot be utilized unless the patients accept and use the services. Disparities in the use of patient portals may exacerbate the already existing inequalities in healthcare access and health outcomes, possibly increasing the digital inequality in the societies.

Objective:

The aim of this study was to examine the factors associated with non-use and dissatisfaction with the Finnish nationwide patient portal My Kanta Pages among the users of healthcare services during the COVID-19 outbreak. Several factors related to sociodemographic characteristics, health and the use of healthcare services, experiences of guidance concerning electronic services, and digital skills and attitudes were evaluated.

Methods:

A national population survey was sent using stratified sampling to 13,200 Finnish residents who had reached the age of 20 years. Data were collected from September 2020 to February 2021 during the COVID-19 pandemic. Respondents who had used healthcare services and the Internet for transactions or for searching for information in the past 12 months were included in the analyses. Bivariate logistic regression analyses were used to examine the adjusted associations of respondent characteristics with the non-use of My Kanta Pages and dissatisfaction with the service. The Inverse Probability Weighting (IPW) method was applied in all statistical analyses to correct for bias.

Results:

In total, n=3919 respondents were included in the study. Most respondents (3330/3919; 85.0 %) used My Kanta Pages and were satisfied (2841/3330, 85.3%). Non-users were a minority (589/3919; 15.0%) among all respondents and only 14.7% (489/3330) of the users were dissatisfied with the service. Especially patients without a long-term illness (OR: 2.14, 95% CI: 1.48–3.10), those who were not referred to electronic healthcare services by a professional (OR: 2.51, 95% CI: 1.70–3.71) and those in need of guidance using online social and healthcare services (OR: 2.26, 95% CI: 1.41–3.65) were more likely non-users of the patient portal. Perceptions of poor health (OR: 2.10, 95% CI: 1.51–2.93) and security concerns (OR: 1.87, 95% CI: 1.33–2.62) were associated with the dissatisfaction with the service.

Conclusions:

Patients without long-term illnesses, those not referred to electronic healthcare services, and those in need of guidance on the use of online social and healthcare services seemed to be more likely non-users of the Finnish nationwide patient portal. Moreover, poor health and security concerns appeared to be associated with dissatisfaction with the service. Interventions to promote the referral to electronic healthcare services by professionals are needed and attention needs to be paid to information security.