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How the digital divide affects patient portal adoption

The ability to use a patient portal or personal health record (PHR) service to view lab results, renew prescriptions and communicate with physicians is a key component of patient-centered care. That, in turn, is arguably the fundamental goal of both health care reform and the HITECH Act.

Two obstacles stand in the way of this goal being realized. One is the poor functionality of patient portals, which often only let patients view information, but not add it. The other pitfall is even more basic — the ability to access a patient portal in the first place.

Recent studies published by the Kaiser Family Foundation and the Archives of Internal Medicine examined racial and income disparities in Internet access and PHR use, respectively.

The findings suggest that lower-income adults are less likely to have Internet access — and, by extension, to use a patient portal — than higher-income adults. (In the Kaiser study, the division between high and low income was set at $40,000 annually.) The two studies also note that, regardless of income level, minorities are less likely to use a patient portal than whites.

Fortunately, this can change. The Boston-based researchers who published their findings in the Archives of Internal Medicine and who studied a single health system found that “an aggressive marketing strategy for PHR enrollment” boosted patient portal use nearly threefold. Moreover, patients with a chronic condition were more likely to use the patient portal, regardless of income, than other patients.

Taken together, the findings suggest that, though the digital divide persists, it can be overcome if patients are convinced that Internet access can be an important tool for improving their health. This sort of patient education, it seems, will be worth the effort.