Ensuring Equitable Access to Patient Portals—Closing the “Techquity” Gap
Kevin B. Johnson, Said A. Ibrahim, S. Trent Rosenbloom
Abstract
Over the past 25 years, patient portals have expanded from small demonstration projects, such as seminal work by Masys et al 1 and Cimino et al, 2 to nearly ubiquitous components of electronic health records.This success has been associated with several factors, including regulatory pressures-eg, the Meaningful Use program and the 21st Century Cures Act-and recent changes to health care delivery models supporting asynchronous and virtual telehealth care.Use of patient portals is also influenced by important but relatively understudied cultural changes in people's expectations of seamless access to all data, including banking, entertainment, social media, and health data.Recent studies suggest that patient portal access is associated with greater engagement by patients in their health care. 3For patients, being in a partnership with a health care team implies full access to one's health information, participation in decision-making, and engaging in self-managed health care.Today's portals enable this degree of partnership by sharing access to most electronic clinical information, including test results, clinical notes taken by health care professionals, and information regarding the patient's general health management.Modern patient portals also uniformly provide patients with tools to send secure messages to their health care team in the context of their medical record, to manage their prescription renewals, arrange appointments, and pay their bills.In many cases, patient portals have become a source of context-based educational materials for many patients and have offered interfaces that support self-management of chronic diseases such as hypertension and diabetes.Adoption and use of patient portals have surged in the US in the past 5 years, making them a crucial channel for timely health care access. 4They now facilitate various health care services, including telehealth, virtual visits, secure messaging, preventive care alerts, previsit screening forms, and patient-reported outcome measures.