Login to Access Video or Poster Abstract: MP76-14
Sources of Funding: Dr. Bush's time was supported in part by grant number R00 HS022404 from the Agency for Healthcare Research and Quality._x000D_

Introduction

As part of the Affordable Care Act, multiple directives for meaningful use of the Electronic Health Record (EHR) have been promoted including the use of a patient/provider portal with the goal of optimizing efficiency of care. Although patient portals are increasingly common, there is little information regarding their use as an engagement tool to connect patients, caregivers, and healthcare teams as partners. Use of the portal by patients and providers for children with chronic illnesses might help alleviate caregiver stresses, and may serve as a potential modality to educate patients and parents on chronic care management. However, portal enrollment patterns have not been fully studied. The Urology Division at a tertiary pediatric academic center provides the necessary patient population to examine adoption patterns.

Methods

We retrospectively assessed adoption and use of Epic's MyChart patient portal from January 2010- June 2016. We examined EHR data from 10,464 patients aged 2- 18 who fit 4 categories: activated (or caretaker activated) MyChart access code; accepted but did not activate a code; declined activation; or activated and then deactivated their account and who had at least one Urology appointment. Differences in adoption rates were examined using chi-square statistics and one-way Analysis of Variance (ANOVA).

Results

Overall, 46.5% of patients offered an access code logged into their MyChart account. Males (X² = 10.2; p=.01); those self-identifying as "Other" (not White, Asian, or African American) (X² 375.0; p<.001); and Hispanic patients (X²= 366.5; p<.001) were less likely to activate their portal account. Patients living in central, urban areas were less likely than those living in suburban areas to activate their accounts (X²= 240.7; p<.001). Using census data for zip code region, patients who activated their account had a significantly higher median household income than those who did not activate, refused, or deactivated their account (F= 135.6; p<.001). Language was significantly associated with adoption. Those who reported their primary language as Spanish were much less likely to activate the portal (X²=895.9; p<.001) (358 of 1704) than English-speaking patients (4405 of 8480).

Conclusions

Our findings suggest that primary language and socioeconomic factors may be a significant barriers in adopting the portal. Focusing on patient education to reduce these barriers, may increase portal acceptance thereby making the portal a more meaningful tool for patients, parents, and providers.

Funding

Dr. Bush's time was supported in part by grant number R00 HS022404 from the Agency for Healthcare Research and Quality._x000D_