The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study
BackgroundDuring the COVID-19 pandemic, the shift to virtual care became essential for the continued care of patients. Individuals with rheumatic and musculoskeletal diseases (RMDs) especially require frequent provider visits and close monitoring. To date, there have been lim...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-08-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2022/8/e38802 |
| _version_ | 1797734781277962240 |
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| author | Enid Y Sun Carolina Alvarez Leigh F Callahan Saira Z Sheikh |
| author_facet | Enid Y Sun Carolina Alvarez Leigh F Callahan Saira Z Sheikh |
| author_sort | Enid Y Sun |
| collection | DOAJ |
| description |
BackgroundDuring the COVID-19 pandemic, the shift to virtual care became essential for the continued care of patients. Individuals with rheumatic and musculoskeletal diseases (RMDs) especially require frequent provider visits and close monitoring. To date, there have been limited studies examining inequities in health technology use among patients with RMDs.
ObjectiveOur goal was to identify characteristics associated with patient portal use before and after the COVID-19 pandemic in a convenience sample of patients with RMDs from a large academic medical center.
MethodsIn this cross-sectional study, Epic electronic medical record data were queried to identify established patients of the University of North Carolina Hospitals adult rheumatology clinic between November 1, 2017, through November 30, 2019. Demographic and clinical data were collected to compare MyChart (Epic’s patient portal) users with nonusers before and after the COVID-19 pandemic. MyChart activation and use were modeled using logistic regression and adjusted odds ratios, and confidence intervals were estimated.
ResultsWe identified 5075 established patients with RMDs who met the inclusion criteria. Prior to the pandemic, we found that younger age (P<.001), suburban residence (P=.05), commercial/state insurance (P<.001), military insurance (P=.05), and median income >US $50,000 (P<.001) were associated with significantly higher odds of MyChart activation. Male sex (P<.001), being of Black or African American (P<.001) or “other” race (P<.001), Spanish as a primary language (P<.001), rural residence (P=.007), Medicaid insurance (P<.001), and median income of <US $25,000 (P=.01) were associated with lower odds of MyChart activation. Following COVID-19, younger age (P<.001), commercial insurance (P=.03), state insurance (P=.02), and median income of US $50,000-75,000 (P=.01) were associated with significantly higher odds of MyChart use. However, being of Black or African American (P<.001) or “other” race (P=.01), Spanish as a primary language (P=.002), male sex (P=.004), rural residence (P=.005), and having no insurance (P<.001) or Medicaid (P=.008) were associated with lower odds of MyChart use.
ConclusionsResidence in a rural area, being of minority race/ethnicity, older age, male sex, lower median income, Medicaid, being uninsured, and non-English primary language are associated with lower odds of patient portal activation and use. Future health policy and clinical practice measures should focus on reducing barriers to health technology adoption among these groups. |
| first_indexed | 2024-03-12T12:49:27Z |
| format | Article |
| id | doaj.art-4d03d389b45d4fef8abcd2c66e8770d0 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:49:27Z |
| publishDate | 2022-08-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-4d03d389b45d4fef8abcd2c66e8770d02023-08-28T22:59:21ZengJMIR PublicationsJournal of Medical Internet Research1438-88712022-08-01248e3880210.2196/38802The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional StudyEnid Y Sunhttps://orcid.org/0000-0003-1369-5799Carolina Alvarezhttps://orcid.org/0000-0003-1409-0898Leigh F Callahanhttps://orcid.org/0000-0001-6362-7220Saira Z Sheikhhttps://orcid.org/0000-0003-4128-0443 BackgroundDuring the COVID-19 pandemic, the shift to virtual care became essential for the continued care of patients. Individuals with rheumatic and musculoskeletal diseases (RMDs) especially require frequent provider visits and close monitoring. To date, there have been limited studies examining inequities in health technology use among patients with RMDs. ObjectiveOur goal was to identify characteristics associated with patient portal use before and after the COVID-19 pandemic in a convenience sample of patients with RMDs from a large academic medical center. MethodsIn this cross-sectional study, Epic electronic medical record data were queried to identify established patients of the University of North Carolina Hospitals adult rheumatology clinic between November 1, 2017, through November 30, 2019. Demographic and clinical data were collected to compare MyChart (Epic’s patient portal) users with nonusers before and after the COVID-19 pandemic. MyChart activation and use were modeled using logistic regression and adjusted odds ratios, and confidence intervals were estimated. ResultsWe identified 5075 established patients with RMDs who met the inclusion criteria. Prior to the pandemic, we found that younger age (P<.001), suburban residence (P=.05), commercial/state insurance (P<.001), military insurance (P=.05), and median income >US $50,000 (P<.001) were associated with significantly higher odds of MyChart activation. Male sex (P<.001), being of Black or African American (P<.001) or “other” race (P<.001), Spanish as a primary language (P<.001), rural residence (P=.007), Medicaid insurance (P<.001), and median income of <US $25,000 (P=.01) were associated with lower odds of MyChart activation. Following COVID-19, younger age (P<.001), commercial insurance (P=.03), state insurance (P=.02), and median income of US $50,000-75,000 (P=.01) were associated with significantly higher odds of MyChart use. However, being of Black or African American (P<.001) or “other” race (P=.01), Spanish as a primary language (P=.002), male sex (P=.004), rural residence (P=.005), and having no insurance (P<.001) or Medicaid (P=.008) were associated with lower odds of MyChart use. ConclusionsResidence in a rural area, being of minority race/ethnicity, older age, male sex, lower median income, Medicaid, being uninsured, and non-English primary language are associated with lower odds of patient portal activation and use. Future health policy and clinical practice measures should focus on reducing barriers to health technology adoption among these groups.https://www.jmir.org/2022/8/e38802 |
| spellingShingle | Enid Y Sun Carolina Alvarez Leigh F Callahan Saira Z Sheikh The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study Journal of Medical Internet Research |
| title | The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study |
| title_full | The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study |
| title_fullStr | The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study |
| title_full_unstemmed | The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study |
| title_short | The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study |
| title_sort | disparities in patient portal use among patients with rheumatic and musculoskeletal diseases retrospective cross sectional study |
| url | https://www.jmir.org/2022/8/e38802 |
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