• Wen-Jan Tuan, Mark Mellott, Brian G Arndt, Jami Jones, and Annie N Simpson.
• From Departments of Family and Community Medicine, and Public Health Sciences, College of Medicine, Pennsylvania State University, Pennsylvania, USA, Hershey, PA (W-JT); Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC, USA, Charleston, SC (MM, JJ, ANS); University of Wisconsin Department of Family Medicine and Community Health, Madison, WI, USA, Madison, WI (BGA). wtuan@pennstatehealth.psu.edu.
• J Am Board Fam Med. 2022 May 1; 35 (3): 559-569.

ObjectiveThis study examined patient portal utilization by analyzing the pattern of time and feature use of patients, and thus to identify functionalities of portal use and patient characteristics that may inform future strategies to enhance communication and care coordination through online portals.MethodsWe conducted a retrospective study of patients at 18 family medicine clinics over a 5-year period using access log records in the electronic health record database. Dimensionality reduction analysis was applied to group portal functionalities into 4 underlying feature domains: messaging, health information management, billing/insurance, and resource/education. Negative binomial regression analysis was used to evaluate how patient and practice characteristics affected the use of each feature domain.ResultsPatients with more chronic conditions, lab tests, or prescriptions generally showed greater patient portal usage. However, patients who were male, elderly, in minority groups, or living in rural areas persistently had lower portal usage. Individuals on public insurance were also less likely than those on commercial insurance to use patient portals, although Medicare patients showed greater portal usage on health information management features, and uninsured patients had greater usage on viewing resource/education features. Having Internet access only affected the use of messaging features.ConclusionEfforts to enroll patients in online portals do not guarantee patients will use the portals to manage their health. When considering the use of patient portals for improving telehealth, clinicians need to be aware of technological, socioeconomic, and cultural challenges faced by their patients.© Copyright 2022 by the American Board of Family Medicine.

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