Patient Portal Use during Home Health Care at an Academic Health System

Abstract

Objectives: To characterize patient portal use among older adults receiving skilled home health (HH) care.

Design: Retrospective cohort study.

Setting and participants: Older adults (aged ≥65 years) who received HH care from a large, academic health system between 2017 to 2022 (n = 8409 HH episodes provided to n = 4878 unique individuals).

Methods: We captured individual and HH episode characteristics from the electronic health record and identified specific types and dates of portal use for those with an active patient portal. We calculated the proportion of episodes in which patients engaged in specific patient portal activities (eg, viewing test results, managing appointments, sending messages). We used multivariable logistic regression to model the odds of engaging in each activity as a function of patient and episode characteristics, and charted the timing of patient portal activities across the 60-day HH episode.

Results: The patient portal was used by older adults in more than half (58%) of the episodes examined. Among those using their portal account during an HH episode, 84% viewed test results, 77% managed an existing appointment, 72% managed medications, and 55% sent a message to a provider. Adjusted odds of portal use were higher among HH patients who were married (aOR: 1.77, P < .001), receiving HH post-COVID pandemic (aOR: 2.73, P < .001), and accessing HH following a hospitalization (aOR: 1.30, P < .001) and lower among those who were Black compared with white (aOR: 0.52, P < .001). Portal use, particularly viewing test results and clinical notes and managing existing appointments, was highest during the first 10 days of an HH episode, especially among patients referred following a hospitalization.

Conclusions and implications: HH patients use the patient portal to perform care management tasks and access clinical information. Study findings support opportunities to harness the patient portal to bridge information gaps and care coordination during HH care.

Keywords: Home health care; MyChart; consumer-facing technology; health information technology; home care; patient portal.

Fig. 1.

Types of portal activities among patients during home health care (n = 4889). Data are from 4889 home health episodes for older adults (age ≥65 years) receiving home health care from an academic health system between 2017 and 2022.

Fig. 2.

Timing of patient portal use during home health episode (n = 4889). Data are from 4889 home health episodes for older adults (age ≥65 years) receiving home health care from an academic health system between 2017 and 2022.

Fig. 3.

Timing of patient portal use during home health care, comparing those who did vs did not have a preceding hospitalization (n = 4889). Data are from 4889 home health episodes for older adults (age ≥65 years) receiving home health care from an academic health system between 2017 and 2022.