Providing patients with access to their personal health records may encourage engagement, but poor and minority patients may be at a disadvantage for accessing the portals.
A study published in the American Journal of Managed Care found that nonwhite patients and patients who spoke Spanish as a primary language tended to access their personal health records less frequently than white, English-speaking patients. The study used a retrospective design including nearly 3.2 million adult patients in the Kaiser Permanente health system, measuring the number of times they accessed the patient portal from December 2010 through the present.
The researchers found that of the entire participant base, 56 percent were registered for the portal. The most likely members to register for the portal were women, non-Hispanic white individuals and people 30 years old or older. Race and ethnicity were the strongest predictors of portal registration, followed by the number of annual office visits, age and language preference. Asian and Pacific Island individuals were 23 percent less likely than white individuals to register, Hispanic members were 55 percent less likely and black individuals were 62 percent less likely.
The researchers also found that 90 percent of the individuals who had registered for the patient portal spoke English as a primary language. The ratio of patients in the population who speak Spanish compared to those who speak English does not match up with the ratio of English-speakers to Spanish-speakers who have registered for the portal, indicating that speaking Spanish as a primary language constitutes a barrier in registering, the researchers wrote.
"The increasing availability of PHRs may have the potential to ameliorate some racial and ethnic differences in health outcomes and health status," the researchers wrote. "However, if disparities in PHR access persist, health disparities may also increase."