Racial/ethnic variation in devices used to access patient portals

Abstract

OBJECTIVES: We examined racial/ethnic variation in the devices used by patients to access medical records through an online patient portal.

STUDY DESIGN: Retrospective, cross-sectional analysis.

METHODS: Using data from 318,700 adults enrolled in an integrated delivery system between December 2012 and November 2013, we examined: 1) online patient portal use that directly engages the electronic health record and 2) portal use over desktops/laptops only, mobile devices only, or both device types. The primary covariate was race/ethnicity (non-Hispanic white, black, Hispanic, and Asian). Other covariates included age, sex, primary language, and neighborhood-level income and education. Portal use and devices used were assessed with multiple and multinomial logistic models, respectively.

RESULTS: From December 2012 to November 2013, 56% of enrollees used the patient portal. Of these portal users, 62% used desktops/laptops only, 6% used mobile devices only, and 32% used both desktops/laptops and mobile devices. Black, Hispanic, and Asian enrollees had significantly lower odds of portal use than whites. Black and Hispanic portal users also were significantly more likely to use mobile devices only (relative risk ratio, 1.73 and 1.44, respectively) and both device types (1.21 and 1.07, respectively) than desktops/laptops only compared with whites.

CONCLUSIONS: Although racial/ethnic minority enrollees were less likely to access the online patient portal overall, a greater proportion of black and Hispanic users accessed the patient portal with mobile devices than did non-Hispanic white users. The rapid spread of mobile devices among racial/ethnic minorities may help reduce variation in online patient portal use. Mobile device use may represent an opportunity for healthcare organizations to further engage black and Hispanic enrollees in online patient portal use.