Written by Rebecca White
Spoon Feed
Patients are increasingly accessing electronic health portals during ED encounters, but disparities in portal access exist – male, Black, and non-commercially insured patients show lower rates of usage.
“Doc, where have you been? My results came back an hour ago!”
Since the inception of the Cures Act, patients have immediate access to their health information with the goal of increasing engagement and autonomy. Studies suggest portal access initiated in the ED is associated with increased clinic attendance and may hasten detection of critical results. Although this information is available to patients, are they accessing it?
In this cross-sectional study, 1,280,924 adult patients presenting at 36 EDs were included. A total of 17.4% logged into the patient portal while in the ED, with 14.1% viewing test results and 2.5% viewing clinical notes. Odds ratios of accessing the portal (OR, 1.36; 95% CI, 1.19-1.56), viewing test results (OR, 1.63; 95% CI, 1.30-2.04), and viewing clinical notes (OR, 1.60; 95% CI, 1.19-2.15) were higher at the end of the study compared to the beginning. Patients with active portal accounts at ED arrival had higher odds of accessing the portal. Patients who were male, Black or without commercial insurance were less likely to use the portal.
How will this change my practice?
True to its role as a safety-net setting, the ED may be the perfect place to address portal enrollment inequities – care navigators could facilitate enrollment and education during wait times. However, the immediate availability of results is a double-edged sword – abnormal results can cause distress while patients wait for updates from their provider. As portal access is increasing, I am making efforts to pre-counsel patients on potential test results and promptly return to bedside to discuss abnormal results.
Source
Real-Time Electronic Patient Portal Use Among Emergency Department Patients. JAMA Netw Open. 2024 May 1;7(5):e249831. doi: 10.1001/jamanetworkopen.2024.9831. PMID: 38700859
