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. 2018 Jul 27;18(1):70.
doi: 10.1186/s12911-018-0644-4.

Patient portal adoption and use by hospitalized cancer patients: a retrospective study of its impact on adverse events, utilization, and patient satisfaction

Duaa Aljabri  1 , Adrian Dumitrascu  2 , M Caroline Burton  2 , Launia White  3 , Mahmud Khan  4 , Sudha Xirasagar  4 , Ronnie Horner  4 , James Naessens  5
Affiliations

Patient portal adoption and use by hospitalized cancer patients: a retrospective study of its impact on adverse events, utilization, and patient satisfaction

Duaa Aljabri et al. BMC Med Inform Decis Mak. .

Abstract

Background: Portal use has been studied among outpatients, but its utility and impact on inpatients is unclear. This study describes portal adoption and use among hospitalized cancer patients and investigates associations with selected safety, utilization, and satisfaction measures.

Methods: A retrospective review of 4594 adult hospitalized cancer patients was conducted between 2012 and 2014 at Mayo Clinic in Jacksonville, Florida, comparing portal adopters, who registered for a portal account prior to hospitalization, with nonadopters. Adopters were classified by their portal activity during hospitalization as active or inactive inpatient users. Univariate and several logistic and linear regression models were used for analysis.

Results: Of total patients, 2352 (51.2%) were portal adopters, and of them, 632 (26.8%) were active inpatient users. Portal adoption was associated with patients who were young, female, married, with higher income, and had more frequent hospitalizations (P < .05). Active inpatient use was associated with patients who were young, married, nonlocals, with higher disease severity, and were hospitalized for medical treatment (P < .05). In univariate analyses, self-management knowledge scores were higher among adopters vs nonadopters (84.3 and 80.0, respectively; P = .01) and among active vs inactive inpatient users (87.0 and 83.3, respectively; P = .04). In regression models adjusted for age and disease severity, the association between portal behaviors and majority of measures were not significant (P > .05).

Conclusions: Over half of our cancer inpatients adopted a portal prior to hospitalization, with increased adoption associated with predisposing and enabling determinants (eg: age, sex, marital status, income), and increased inpatient use associated with need (eg: nonlocal residence and disease severity). Additional research and greater effort to expand the portal functionality is needed to impact inpatient outcomes.

Keywords: Adverse events; Cancer; Hospitalization; Portal; Satisfaction; Utilization.

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Conflict of interest statement

Ethics approval and consent to participate

This study was a retrospective study of existing records, and a waiver of informed consent was approved by the Mayo Clinic Institutional Review Board in accordance with 45 CFR 46.116 (Approval #14–00603).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study Theoretical Model Derived from Andersen’s Model of Healthcare Utilization. 1 Predisposing factors: age, sex, and race. 2 Enabling factors: marital status, employment status, health insurance type, and income. 3 Need factors: geographic area of residence, comorbidities, and frequency of hospitalizations. Additional need factors related to the admission: MSDRG type and APRDRG disease severity weight. APRDRG indicates All Patients Refined Diagnostic Related Group; MSDRG, Medicare Severity-Diagnosis Related Group
See this image and copyright information in PMC

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