Predictors and patterns of portal use in patients with multiple chronic conditions

To explore predictors of portal use by patients (registered portal users) with multiple chronic conditions according to demographic characteristics and use of specific features hypothesized to support self-management.

Two data sources were used in this analysis: electronic health records and 12 months of data from web server log files. Patients (n = 500) included in the analysis were 45 years or older, registered portal users, and diagnosed with at least two chronic conditions. We fit a negative binomial regression model to predict portal use (number of logins) based on practice size and location, demographic characteristics, and use of specific portal features (secure messaging and patient-entered data).

Among patients with one or more logins, age, distance separating the patient from his or her primary care provider, and having a diagnosis of heart failure were significant predictors of portal use (p < .05). No significant differences in portal use were found according to gender, ethnicity, or practice size and location.

Considering the extraordinary investment on implementation and meaningful use of portal technology, low overall use and the large number of registered non-users is especially troubling. Regardless, our results demonstrate potential opportunities to leverage portal technology especially for patients living in rural and underserved areas to improve self-management of chronic illness.