Use of a Patient Portal for Engaging Patients with Type 2 Diabetes: Patterns and Prediction

Patient portals empower patients by providing access to their health information and facilitating communication with care providers. This study aimed to examine the usage patterns of a patient portal offered as part of an electronic health record and to identify predictors of portal use among patients with type 2 diabetes (T2DM). A 2-year retrospective cohort study was performed using outpatient data from the health care system and its patient portal. Demographic and clinical data from 38,399 T2DM patients were analyzed. Descriptive statistics were used to summarize portal usage patterns. Binary logistic regression was employed to examine predictors and two-way interactions associated with portal use. Almost one-third of patients (n = 12,615; 32.9%, 95% confidence interval: [32.38%-33.32%]) had used the portal for a mean 2.5 ± 1.9 years before the study period. Portal use was higher on weekdays than on weekends (P < 0.001). An increase in portal use was observed in response to e-mail reminders. A nonlinear relationship between age and portal use was observed and depended on several other predictors (P's < 0.05). Patients living in more rural areas with low income were at lower odds to use the portal (P = 0.021), and this finding also applied to nonwhites with low income (P < 0.001). More chronic conditions and a higher initial glycated hemoglobin value were associated with portal use (P = 0.014). The patient portal usage remained relatively stable over the 2-year period. A combination of factors was associated with an individual's patient portal use. Patient engagement in portal use can be facilitated through a proactive approach by health care providers.