{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:50:58Z","timestamp":1777942258568,"version":"3.51.4"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of this study was to identify racial and ethnic disparities in patient portal offers, access, and use and to examine the role of providers in facilitating access to electronic health information (EHI) by offering patient portals and encouraging their use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Using nationally representative survey data from 2019 and 2020 (N\u2009=\u20098028), we examined disparities in patients being offered access to a portal by their provider and differences in subsequent access and use. Using multivariable models, we estimated the effect of race and ethnicity on the likelihood of being offered, accessing or using a portal. Among those offered, we examined the relationship between provider encouragement and portal access; and for those who did not access their portal, we explored reasons for nonuse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Black and Hispanic individuals were offered and accessed patient portals at significantly lower rates than White individuals. Compared to Whites, Black and Hispanic individuals were 5.2 percentage-points less likely to be offered a portal (P &amp;lt; .05) and, among those offered, 7.9 percentage-points less likely to access their portal (P &amp;lt; .05). Black and Hispanic individuals who were offered and accessed a portal were 12 percentage-points more likely than Whites to use it to download or transmit information (P &amp;lt; .01). Individuals who were offered a portal and encouraged to use it were 21 percentage-points more likely to access it.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Differences in patient portal access and use are likely driven by disparities in which groups of patients reported being offered a portal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Providers play an important role in increasing access to EHI by facilitating access to patient portals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocac227","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T06:17:29Z","timestamp":1668665849000},"page":"308-317","source":"Crossref","is-referenced-by-count":93,"title":["Disparities in patient portal access and the role of providers in encouraging access and use"],"prefix":"10.1093","volume":"30","author":[{"given":"Chelsea","family":"Richwine","sequence":"first","affiliation":[{"name":"Office of the National Coordinator for Health Information Technology, Office of Technology , Washington, District of Columbia, USA"}]},{"given":"Christian","family":"Johnson","sequence":"additional","affiliation":[{"name":"Office of the National Coordinator for Health Information Technology, Office of Technology , Washington, District of Columbia, USA"}]},{"given":"Vaishali","family":"Patel","sequence":"additional","affiliation":[{"name":"Office of the National Coordinator for Health Information Technology, Office of Technology , Washington, District of Columbia, USA"}]}],"member":"286","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"2023011811032200000_ocac227-B1","author":"Office of the National Coordinator for Health Information Technology"},{"key":"2023011811032200000_ocac227-B2","author":"Office of the National Coordinator for Health Information Technology"},{"key":"2023011811032200000_ocac227-B3","author":"U.S. Department of Health and Human Services. Health Information Privacy","year":"2017"},{"key":"2023011811032200000_ocac227-B4","year":"2016"},{"key":"2023011811032200000_ocac227-B5","author":"U.S. Department of Health and Human Services","year":"2020"},{"issue":"4","key":"2023011811032200000_ocac227-B6","doi-asserted-by":"crossref","first-page":"e12779","DOI":"10.2196\/12779","article-title":"Patient portals facilitating engagement with inpatient electronic medical records: a systematic review","volume":"21","author":"Dendere","year":"2019","journal-title":"J Med Internet Res"},{"key":"2023011811032200000_ocac227-B7","author":"Epic Research","year":"2021"},{"key":"2023011811032200000_ocac227-B8","doi-asserted-by":"publisher","DOI":"10.1377\/hpb20130214.898775","article-title":"Patient engagement","volume":"Feb 14:","author":"James","year":"2013","journal-title":"Health Affairs Health Policy Brief"},{"key":"2023011811032200000_ocac227-B9","author":"U.S. Department of Health and Human Services","year":"2012"},{"key":"2023011811032200000_ocac227-B10","author":"Office of the National Coordinator for Health Information Technology"},{"key":"2023011811032200000_ocac227-B11","author":"Coelius"},{"key":"2023011811032200000_ocac227-B12","author":"National Center for Health Statistics"},{"key":"2023011811032200000_ocac227-B13","author":"Johnson","year":"2021"},{"key":"2023011811032200000_ocac227-B14","author":"Westat"},{"key":"2023011811032200000_ocac227-B15","author":"Westat"},{"key":"2023011811032200000_ocac227-B16","author":"Patel"},{"issue":"3","key":"2023011811032200000_ocac227-B17","doi-asserted-by":"crossref","first-page":"220","DOI":"10.4258\/hir.2020.26.3.220","article-title":"Impact of digital divide on the adoption of online patient portals for self-motivated patients","volume":"26","author":"Otokiti","year":"2020","journal-title":"Healthc Inform Res"},{"issue":"10","key":"2023011811032200000_ocac227-B18","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s11606-011-1749-y","article-title":"Use of an electronic patient portal among disadvantaged populations","volume":"26","author":"Ancker","year":"2011","journal-title":"J Gen Intern Med"},{"issue":"e1","key":"2023011811032200000_ocac227-B19","doi-asserted-by":"crossref","first-page":"e173","DOI":"10.1093\/jamia\/ocw095","article-title":"Patient portals and personal health information online: perception, access, and use by US adults","volume":"24","author":"Peacock","year":"2017","journal-title":"J Am Med Inform Assoc"},{"issue":"3","key":"2023011811032200000_ocac227-B20","doi-asserted-by":"crossref","first-page":"e50","DOI":"10.2196\/jmir.5105","article-title":"Differences in access to and preferences for using patient portals and other eHealth technologies based on race, ethnicity, and age: a database and survey study of seniors in a large health plan","volume":"18","author":"Gordon","year":"2016","journal-title":"J Med Internet Res"},{"issue":"5","key":"2023011811032200000_ocac227-B21","doi-asserted-by":"crossref","first-page":"592","DOI":"10.3122\/jabfm.2016.05.160046","article-title":"Patterns of electronic portal use among vulnerable patients in a nationwide practice-based research network: from the OCHIN practice-based research network (PBRN)","volume":"29","author":"Wallace","year":"2016","journal-title":"J Am Board Fam Med"},{"issue":"10","key":"2023011811032200000_ocac227-B22","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1007\/s11606-011-1728-3","article-title":"Disparities in enrollment and use of an electronic patient portal","volume":"26","author":"Goel","year":"2011","journal-title":"J Gen Intern Med"},{"issue":"5","key":"2023011811032200000_ocac227-B23","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1197\/jamia.M3169","article-title":"Disparities in use of a personal health record in a managed care organization","volume":"16","author":"Roblin","year":"2009","journal-title":"J Am Med Inform Assoc"},{"issue":"3","key":"2023011811032200000_ocac227-B24","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1136\/jamia.2010.006015","article-title":"Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access","volume":"18","author":"Sarkar","year":"2011","journal-title":"J Am Med Inform Assoc"},{"issue":"12","key":"2023011811032200000_ocac227-B25","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1377\/hlthaff.2018.05117","article-title":"Who isn\u2019t using patient portals and why? Evidence and implications from a national sample of US adults","volume":"37","author":"Anthony","year":"2018","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"2023011811032200000_ocac227-B26","doi-asserted-by":"crossref","first-page":"33","DOI":"10.37765\/ajmc.2021.88575","article-title":"Barriers to accessing online medical records in the United States","volume":"27","author":"Trivedi","year":"2021","journal-title":"Am J Manag Care"},{"issue":"10","key":"2023011811032200000_ocac227-B27","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1093\/jamia\/ocz026","article-title":"Role of provider encouragement on patient engagement via online portals","volume":"26","author":"Shimoga","year":"2019","journal-title":"J Am Med Inform Assoc"},{"key":"2023011811032200000_ocac227-B28","year":"2019"},{"key":"2023011811032200000_ocac227-B29","author":"Westat","year":"2022"},{"key":"2023011811032200000_ocac227-B30","author":"Westat","year":"2022"},{"issue":"10","key":"2023011811032200000_ocac227-B31","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.annepidem.2012.07.008","article-title":"Toward a better understanding of when to apply propensity scoring: a comparison with conventional regression in ethnic disparities research","volume":"22","author":"Ye","year":"2012","journal-title":"Ann Epidemiol"},{"key":"2023011811032200000_ocac227-B32","author":"Health Level Seven","year":"2022"},{"key":"2023011811032200000_ocac227-B33","author":"Apple Registration Guide for Healthcare Organizations","year":"2022"},{"issue":"1","key":"2023011811032200000_ocac227-B34","doi-asserted-by":"crossref","first-page":"e14512","DOI":"10.2196\/14512","article-title":"Back to the future: achieving health equity through health informatics and digital health","volume":"8","author":"Brewer","year":"2020","journal-title":"JMIR Mhealth Uhealth"},{"issue":"8\u20139","key":"2023011811032200000_ocac227-B35","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1093\/jamia\/ocz023","article-title":"Interventions to increase patient portal use in vulnerable populations: a systematic review","volume":"26","author":"Grossman","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"10","key":"2023011811032200000_ocac227-B36","doi-asserted-by":"crossref","first-page":"e5910","DOI":"10.2196\/jmir.5910","article-title":"\u201cI want to keep the personal relationship with my doctor\u201d: understanding barriers to portal use among African Americans and Latinos","volume":"18","author":"Lyles","year":"2016","journal-title":"J Med Internet Res"},{"key":"2023011811032200000_ocac227-B37","author":"Health Information Technology, Evaluation, and Quality Center","year":"2016"},{"issue":"1","key":"2023011811032200000_ocac227-B38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.hlpt.2016.11.004","article-title":"Access policy and the digital divide in patient access to medical records","volume":"6","author":"Ancker","year":"2017","journal-title":"Health Policy Technol2017"},{"issue":"1","key":"2023011811032200000_ocac227-B39","doi-asserted-by":"crossref","first-page":"36","DOI":"10.37765\/ajmc.2022.88814","article-title":"Addressing virtual care disparities for patients with limited English proficiency","volume":"28","author":"Tan-McGrory","year":"2022","journal-title":"Am J Manag Care"},{"key":"2023011811032200000_ocac227-B40","author":"Argentieri","year":"2022"},{"issue":"1","key":"2023011811032200000_ocac227-B41","first-page":"e1","article-title":"Racial\/ethnic variation in devices used to access patient portals","volume":"24","author":"Chang","year":"2018","journal-title":"Am J Manag Care"},{"issue":"5","key":"2023011811032200000_ocac227-B42","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1215\/03616878-3940477","article-title":"Missed opportunity? Leveraging mobile technology to reduce racial health disparities","volume":"42","author":"Ray","year":"2017","journal-title":"J Health Polit Policy Law"},{"issue":"3","key":"2023011811032200000_ocac227-B43","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.hjdsi.2016.08.004","article-title":"Patient portals and health apps: Pitfalls, promises, and what one might learn from the other","volume":"5","author":"Baldwin","year":"2017","journal-title":"Healthc (Amst)"},{"issue":"Supplement 1","key":"2023011811032200000_ocac227-B44","doi-asserted-by":"crossref","first-page":"i8","DOI":"10.1136\/amiajnl-2011-000473","article-title":"Patient reported barriers to enrolling in a patient portal","volume":"18","author":"Goel","year":"2011","journal-title":"J Am Med Inform Assoc"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/30\/2\/308\/48754868\/ocac227.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/30\/2\/308\/48754868\/ocac227.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T11:03:56Z","timestamp":1674039836000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/30\/2\/308\/6855146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":44,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,11,30]]},"published-print":{"date-parts":[[2023,1,18]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocac227","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2022,11,30]]}}}