JMIR Publications

ABSTRACT

Background:

Patients with cancer were reported to use patient portals far more frequently than other patient populations and patient portals have shown the potential to deepen relationships between care providers and cancer patients by increasing transparency of health information and supporting communication.

Objective:

The objective of this study was to examine the causal relationship between the usage of patient portals and cancer patients’ health self-efficacy outcomes.

Methods:

The National Institute’s HINTS 5 Cycle 1 (2017), Cycle 2 (2018), Cycle 3 (2019), and Cycle 4 (2020) data were used to perform a secondary data analysis. Patients who reported being ever diagnosed with cancer were included in the study population. Their portal usage frequency was considered as an intervention. Patients’ perceptions of self-efficacious health information-seeking behaviors, their capability to perform self-care, and the quality of care received were the primary outcomes considered and they were measured by survey respondents’ self-reported information. A set of conditional independence tests based on the causal directed acyclic graph were developed to examine the causal relationship between patient portal usage and the targeted outcomes.

Results:

We observed patient portals’ impact on strengthening cancer patients’ ability to take care of their own health and identified heterogeneous causal relationships between frequent patient portal usage and cancer patients’ perceived quality of care. We could not conclusively determine the causal effect between patient portal usage and patients’ confidence in getting advice or information about health or cancer care related topics.

Conclusions:

The results advocate patient portals and promote the need to provide better support and education to patients. The proposed statistical method exploits the potential of national survey data for causal inference studies.