Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 23;22(10):e16835.
doi: 10.2196/16835.

Portals of Change: How Patient Portals Will Ultimately Work for Safety Net Populations

Alejandra Casillas  1 , Anshu Abhat #  2 , Anish Mahajan  2 , Gerardo Moreno  3 , Arleen F Brown  1 , Sara Simmons  2 , Peter Szilagyi  4
Affiliations

Portals of Change: How Patient Portals Will Ultimately Work for Safety Net Populations

Alejandra Casillas et al. J Med Internet Res. .

Abstract

Despite the implementation of internet patient portals into the safety net after the introduction of the Affordable Care Act in the United States, little attention has been paid to the process of engaging vulnerable patients into these portals. The portal is a health technology tool that was developed with a mainstream, English-speaking audience in mind. Thus, there are valid concerns that such technologies will actually exacerbate health care disparities, conferring further advantages to the already advantaged. In this paper, we describe a framework for portal engagement (awareness, registration, and use) among safety net patients. We incorporate the experiences in the Los Angeles County Department of Health Services to illustrate important contextual factors for portal outreach in our safety net. Finally, we discuss considerations for moving forward with health technology in the safety net as the next version of patient portals are being developed.

Keywords: digital divide; health disparities; patient portal; safety net.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Los Angeles County Department of Health Services portal features timeline and percentage of empaneled primary care patients enrolled at each stage.
Figure 2
Figure 2
Implementation framework for portal registration and use among safety net patients.
See this image and copyright information in PMC

References

    1. Kruse CS, Bolton K, Freriks G. The effect of patient portals on quality outcomes and its implications to meaningful use: a systematic review. J Med Internet Res. 2015 Feb 10;17(2):e44. doi: 10.2196/jmir.3171. https://www.jmir.org/2015/2/e44/ - DOI - PMC - PubMed
    1. Kamo N, Bender AJ, Kalmady K, Blackmore CC. Meaningful use of the electronic patient portal - Virginia Mason's journey to create the perfect online patient experience. Healthc (Amst) 2017 Dec;5(4):221–226. doi: 10.1016/j.hjdsi.2016.09.003. - DOI - PubMed
    1. Goldzweig C, Towfigh A, Paige N, Orshansky G, Haggstrom D, Beroes J, Evidence-based Synthesis Program . Systematic Review: Secure Messaging Between Providers and Patients, and Patients' Access to Their Own Medical Record. Evidence on Health Outcomes, Satisfaction, Efficiency and Attitudes. Washington DC: Department of Veterans Affairs (US); 2012. - PubMed
    1. Ralston JD, Hirsch IB, Hoath J, Mullen M, Cheadle A, Goldberg HI. Web-based collaborative care for type 2 diabetes: a pilot randomized trial. Diabetes Care. 2009 Feb;32(2):234–239. doi: 10.2337/dc08-1220. http://europepmc.org/abstract/MED/19017773 - DOI - PMC - PubMed
    1. Sarkar U, Lyles CR, Parker MM, Allen J, Nguyen R, Moffet HH, Schillinger D, Karter AJ. Use of the refill function through an online patient portal is associated with improved adherence to statins in an integrated health system. Med Care. 2014 Mar;52(3):194–201. doi: 10.1097/MLR.0000000000000069. http://europepmc.org/abstract/MED/24374412 - DOI - PMC - PubMed

Publication types