Geographic Location Impacts Patient Portal Use via Desktop and Mobile Devices

Disparities in patient portal use are impacted by individuals' access to technology and the internet as well as their skills and health behaviors. An individual's geographic location may impact these factors as well as contribute to their decision to use a portal, their choice of device to access the portal, and their use of portal functions. This study evaluated patient portal use by geographic location according to three comparators: proximity to the medical center offering the portal, urban/rural classification, and degree of digital distress. Patients residing farther from the medical center, in rural areas, or in areas of higher digital distress were less likely to be active portal users. Patients in areas of higher digital distress were more likely to use the mobile portal application instead of the desktop portal website alone. Users of the mobile portal application used portal functions more frequently, and being a mobile user had a greater impact on the use of some portal functions by patients residing in areas of higher digital distress. Mobile patient portal applications have the potential to increase portal use, but work is needed to ensure equitable internet access, to promote mobile patient portal applications, and to cultivate individuals' skills to use portals.