Lisa V Grossman1, Ruth M Masterson Creber2, Jessica S Ancker2, Beatriz Ryan3, Fernanda Polubriaginof3, Min Qian4, Irma Alarcon1, Susan Restaino5, Suzanne Bakken1, George Hripcsak1, David K Vawdrey1,3. 1. Department of Biomedical Informatics, Columbia University, New York, New York, United States. 2. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, United States. 3. Value Institute, New York-Presbyterian Hospital, New York, New York, United States. 4. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, United States. 5. Department of Medicine, New York-Presbyterian Hospital, New York, New York, United States.
Abstract
BACKGROUND: Disadvantaged populations, including minorities and the elderly, use patient portals less often than relatively more advantaged populations. Limited access to and experience with technology contribute to these disparities. Free access to devices, the Internet, and technical assistance may eliminate disparities in portal use. OBJECTIVE: To examine predictors of frequent versus infrequent portal use among hospitalized patients who received free access to an iPad, the Internet, and technical assistance. MATERIALS AND METHODS: This subgroup analysis includes 146 intervention-arm participants from a pragmatic randomized controlled trial of an inpatient portal. The participants received free access to an iPad and inpatient portal while hospitalized on medical and surgical cardiac units, together with hands-on help using them. We used logistic regression to identify characteristics predictive of frequent use. RESULTS: More technology experience (adjusted odds ratio [OR] = 5.39, p = 0.049), less severe illness (adjusted OR = 2.07, p = 0.077), and private insurance (adjusted OR = 2.25, p = 0.043) predicted frequent use, with a predictive performance (area under the curve) of 65.6%. No significant differences in age, gender, race, ethnicity, level of education, employment status, or patient activation existed between the frequent and infrequent users in bivariate analyses. Significantly more frequent users noticed medical errors during their hospital stay. DISCUSSION AND CONCLUSION: Portal use was not associated with several sociodemographic characteristics previously found to limit use in the inpatient setting. However, limited technology experience and high illness severity were still barriers to frequent use. Future work should explore additional strategies, such as enrolling health care proxies and improving usability, to reduce potential disparities in portal use. Georg Thieme Verlag KG Stuttgart · New York.
RCT Entities:
BACKGROUND: Disadvantaged populations, including minorities and the elderly, use patient portals less often than relatively more advantaged populations. Limited access to and experience with technology contribute to these disparities. Free access to devices, the Internet, and technical assistance may eliminate disparities in portal use. OBJECTIVE: To examine predictors of frequent versus infrequent portal use among hospitalized patients who received free access to an iPad, the Internet, and technical assistance. MATERIALS AND METHODS: This subgroup analysis includes 146 intervention-arm participants from a pragmatic randomized controlled trial of an inpatient portal. The participants received free access to an iPad and inpatient portal while hospitalized on medical and surgical cardiac units, together with hands-on help using them. We used logistic regression to identify characteristics predictive of frequent use. RESULTS: More technology experience (adjusted odds ratio [OR] = 5.39, p = 0.049), less severe illness (adjusted OR = 2.07, p = 0.077), and private insurance (adjusted OR = 2.25, p = 0.043) predicted frequent use, with a predictive performance (area under the curve) of 65.6%. No significant differences in age, gender, race, ethnicity, level of education, employment status, or patient activation existed between the frequent and infrequent users in bivariate analyses. Significantly more frequent users noticed medical errors during their hospital stay. DISCUSSION AND CONCLUSION: Portal use was not associated with several sociodemographic characteristics previously found to limit use in the inpatient setting. However, limited technology experience and high illness severity were still barriers to frequent use. Future work should explore additional strategies, such as enrolling health care proxies and improving usability, to reduce potential disparities in portal use. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Mita Sanghavi Goel; Tiffany L Brown; Adam Williams; Andrew J Cooper; Romana Hasnain-Wynia; David W Baker Journal: J Am Med Inform Assoc Date: 2011-11-09 Impact factor: 4.497
Authors: Ruth M Masterson Creber; Lisa V Grossman; Beatriz Ryan; Min Qian; Fernanda C G Polubriaginof; Susan Restaino; Suzanne Bakken; George Hripcsak; David K Vawdrey Journal: J Am Med Inform Assoc Date: 2019-02-01 Impact factor: 4.497
Authors: Julia Adler-Milstein; Catherine M DesRoches; Michael F Furukawa; Chantal Worzala; Dustin Charles; Peter Kralovec; Samantha Stalley; Ashish K Jha Journal: Health Aff (Millwood) Date: 2014-08-07 Impact factor: 6.301
Authors: Jorie M Butler; Marjorie Carter; Candace Hayden; Bryan Gibson; Charlene Weir; Laverne Snow; Jose Morales; Anne Smith; Kim Bateman; Adi V Gundlapalli; Matthew Samore Journal: AMIA Annu Symp Proc Date: 2013-11-16
Authors: Jennifer E Prey; Min Qian; Susan Restaino; Judith Hibbard; Suzanne Bakken; Rebecca Schnall; Gloria Rothenberg; David K Vawdrey; Ruth Masterson Creber Journal: Patient Educ Couns Date: 2016-06-27
Authors: Daniel M Walker; Alice Gaughan; Naleef Fareed; Susan Moffatt-Bruce; Ann Scheck McAlearney Journal: Appl Clin Inform Date: 2019-11-27 Impact factor: 2.342
Authors: Ann Scheck McAlearney; Daniel M Walker; Alice Gaughan; Susan Moffatt-Bruce; Timothy R Huerta Journal: Telemed J E Health Date: 2020-01-28 Impact factor: 3.536
Authors: Alice A Gaughan; Daniel M Walker; Lindsey N Sova; Shonda Vink; Susan D Moffatt-Bruce; Ann Scheck McAlearney Journal: Appl Clin Inform Date: 2022-04-13 Impact factor: 2.342
Authors: Gennaro Di Tosto; Daniel M Walker; Cynthia J Sieck; Lorraine Wallace; Sarah R MacEwan; Megan E Gregory; Seth Scarborough; Timothy R Huerta; Ann Scheck McAlearney Journal: Appl Clin Inform Date: 2022-07-06 Impact factor: 2.762
Authors: Anuj K Dalal; Nicholas Piniella; Theresa E Fuller; Denise Pong; Michael Pardo; Nathaniel Bessa; Catherine Yoon; Stuart Lipsitz; Jeffrey L Schnipper Journal: J Am Med Inform Assoc Date: 2021-03-18 Impact factor: 4.497
Authors: Ann Scheck McAlearney; Daniel M Walker; Cynthia J Sieck; Naleef Fareed; Sarah R MacEwan; Jennifer L Hefner; Gennaro Di Tosto; Alice Gaughan; Lindsey N Sova; Laura J Rush; Susan Moffatt-Bruce; Milisa K Rizer; Timothy R Huerta Journal: JAMA Netw Open Date: 2022-09-01