Disparities in Access and Utilization of Electronic Health Record Patient Portals

Objective: The aim of this study was to assess changes in the accessibility and utilization of electronic health record patient portals in recent years, focusing on whether these changes occurred equitably across different racial, ethnic, and socioeconomic groups. Materials and Methods: The study utilized nationally representative samples from the 2019 and 2022 Health Information National Trends Surveys. A difference-in-differences design was used to determine if increases in access and utilization occurred equally for all segments of the population. Results: From 2019 to 2022, the proportion of people reporting being offered access to a patient portal by a healthcare provider increased from 72.3 to 83.7% and the proportion who reported using a portal increased from 68.0 to 81.9%. African American or Black respondents had similar increases in access and utilization of portals as non-Hispanic Whites, but disparities remained. Hispanics, who were more likely to utilize patient portals in 2019, saw a smaller increase in utilization than non-Hispanic Whites. Increasing disparities in access and/or utilization of patient portals was observed among people with lower household incomes, people without college degrees, and people over the age of 65. Conclusion: An increased reliance on digital healthcare technologies has increased patient portal accessibility and utilization; however, increases have not been equitable across all demographic groups with many disparities persisting or worsening.