{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T01:53:34Z","timestamp":1767837214476,"version":"3.49.0"},"reference-count":78,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Driven by beneficial patient-centered outcomes associated with patient portal use and the Affordable Care Act, portal implementation has expanded into safety nets\u2014health systems that offer access to care to a large share of uninsured, Medicaid, and other vulnerable populations. However, little attention has been paid to the factors that affect portal accessibility by the vulnerable patients served by these health systems\u2014including those who are limited English proficient (LEP).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>The Los Angeles County Department of Health Services (LAC DHS), the second-largest safety net system in the nation, launched its first patient portal, and one of the few bilingual English-Spanish interfaces in existence, in March of 2015. To explore portal awareness and perceptions, we conducted focus groups with LAC DHS patients, in English and Spanish (LEP). The Technology Acceptance Model was used to guide thematic analysis of focus group data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 46 participants, 37 were patients and 9 were caretakers; 23 were English-speaking and 23 Spanish-speaking LEP. All patients had diabetes or hypertension. Over half had an annual household income &amp;lt;$10 000, yet 78% of English-speaking and 65% of Spanish-speaking LEP participants reported at-home Internet access. Participants\u2019 discussion centered around 3 major thematic narratives: (1) participants\u2019 awareness or attitudes about the LAC DHS portal; (2) role of culture, language, or community with regard to portal accessibility and utility; and (3) perceived needs for successful portal implementation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Safety net participants identified concrete benefits to the portal and emphasized the need for portal engagement that offered accessible education, support, and resources in clinical and community settings. The portal offers an additional opportunity to engage the patient and family with trusted and validated health information, and should be further developed in this capacity. This study provides a better understanding of preferred improvements of patient portal engagement that guide broader health technology efforts to address electronic health disparities.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocz115","type":"journal-article","created":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T12:27:29Z","timestamp":1560515249000},"page":"1525-1535","source":"Crossref","is-referenced-by-count":24,"title":["Su salud a la mano (your health at hand): patient perceptions about a bilingual patient portal in the Los Angeles safety net"],"prefix":"10.1093","volume":"26","author":[{"given":"Alejandra","family":"Casillas","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"}]},{"given":"Giselle","family":"Perez-Aguilar","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"}]},{"given":"Anshu","family":"Abhat","sequence":"additional","affiliation":[{"name":"Department of Health Services, Harbor-UCLA Medical Center, Torrance, California, USA"}]},{"given":"Griselda","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Health Services, Harbor-UCLA Medical Center, Torrance, California, USA"}]},{"given":"Tanya T","family":"Olmos-Ochoa","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles Healthcare System, Los Angeles, California, USA"}]},{"given":"Carmen","family":"Mendez","sequence":"additional","affiliation":[{"name":"Department of Health Services, Harbor-UCLA Medical Center, Torrance, California, USA"}]},{"given":"Anish","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Health Services, Harbor-UCLA Medical Center, Torrance, California, USA"}]},{"given":"Arleen","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"}]},{"given":"Gerardo","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA"}]}],"member":"286","published-online":{"date-parts":[[2019,8,2]]},"reference":[{"key":"2020110613005501700_ocz115-B1","doi-asserted-by":"crossref","first-page":"559.","DOI":"10.1186\/s12913-015-1208-2","article-title":"The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: a qualitative study of Kaiser Permanente","volume":"15","author":"Otte-Trojel","year":"2015","journal-title":"BMC Health Serv 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