JMIR Publications

ABSTRACT

Background:

Patient portals are a common electronic medical record tool that allow for the asynchronous exchange of health information between patients and their healthcare teams.

Objective:

We sought to identify if patient portal use modifies readmissions in cirrhosis.

Methods:

We identified 131 patients with decompensated cirrhosis with an index cirrhosis-related admission between 5/1/2018 and 5/1/2019. We then examined patient portal enrollment and use during the prior 6 months. Usage was categorized as active (sending a message) and passive (reading a message or test result), and was further stratified as no, moderate, or frequent use. The primary outcomes were 90-day and overall readmissions, adjusted for age, MELD-Na, alcohol-related cirrhosis, ascites, and hepatic encephalopathy.

Results:

Enrollment in the patient portal was 63.4%. Combined, 97.6% of patients were moderate or frequent passive users for both reading a message or reading a test result. Moderate active users had less 90-day (OR 0.77, 95%CI 0.60-1.00) and overall readmissions (SHR 0.42, 95%CI 0.21-0.84), compared to non-active users. There was no relationship between readmissions and passive use.

Conclusions:

Passive use of the patient portal is very high but does not modify the risk of readmissions. However, moderate active use of the patient portal is associated with a reduced risk of readmissions in decompensated cirrhosis. Further work is needed to identify possible confounders and to refine key usage behaviors that may be protective in regards to readmission.