Correlates of patient portal enrollment and activation in primary care pediatrics

Area of Science:

• Pediatric Primary Care
• Health Informatics
• Health Services Research

Background:

• Patient portals are increasingly integrated into healthcare systems to enhance patient engagement.
• Understanding enrollment and activation patterns is crucial for equitable access and utilization of digital health tools.
• Previous research has highlighted disparities in digital health tool adoption, but specific predictors in pediatric primary care require further investigation.

Purpose of the Study:

• To identify demographic, practice site, and clinical predictors of patient portal enrollment and activation.
• To analyze factors influencing the likelihood of children enrolling in and activating their patient portal accounts.
• To address potential disparities in patient portal utilization within a pediatric primary care setting.

Main Methods:

• A cross-sectional analysis was performed using the primary care database of an academic children's hospital.
• Data from 84,015 children over a 4-year period following the introduction of a patient portal were analyzed.
• Statistical methods were used to determine adjusted odds ratios for enrollment and activation based on various predictors.

Main Results:

• Overall, 38% of children enrolled in the patient portal, with 26% activating their accounts.
• Enrollment was lower for adolescents, Medicaid recipients, low-income families, and certain racial/ethnic groups (Asian, other race, Hispanic).
• Portal activation was decreased for Medicaid/uninsured, Black/other race, and Hispanic patients, but increased for infants, those at resident continuity sites, living farther away, with more office encounters, and more complex health issues.

Conclusions:

• Significant sociodemographic disparities exist in patient portal enrollment and activation within pediatric primary care.
• Factors such as attending a resident continuity practice, greater distance from the practice, higher encounter frequency, and more health problem list items are associated with increased portal activation.
• These findings underscore the need for targeted strategies to promote equitable patient portal use among diverse pediatric populations.