Interventions to increase patient portal use in vulnerable populations: a systematic review
Open accessAbstract
Background: More than 100 studies document disparities in patient portal use among vulnerable populations. Developing and testing strategies to reduce disparities in use is essential to ensure portals benefit all populations. Objective: To systematically review the impact of interventions designed to: (1) increase portal use or predictors of use in vulnerable patient populations, or (2) reduce disparities in use. Materials and Methods: A librarian searched Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Reviews for studies published before September 1, 2018. Two reviewers independently selected English-language research articles that evaluated any interventions designed to impact an eligible outcome. One reviewer extracted data and categorized interventions, then another assessed accuracy. Two reviewers independently assessed risk of bias. Results: Out of 18 included studies, 15 (83%) assessed an intervention's impact on portal use, 7 (39%) on predictors of use, and 1 (6%) on disparities in use. Most interventions studied focused on the individual (13 out of 26, 50%), as opposed to facilitating conditions, such as the tool, task, environment, or organization (SEIPS model). Twelve studies (67%) reported a statistically significant increase in portal use or predictors of use, or reduced disparities. Five studies (28%) had high or unclear risk of bias. Conclusion: Individually focused interventions have the most evidence for increasing portal use in vulnerable populations. Interventions affecting other system elements (tool, task, environment, organization) have not been sufficiently studied to draw conclusions. Given the well-established evidence for disparities in use and the limited research on effective interventions, research should move beyond identifying disparities to systematically addressing them at multiple levels.
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Minority populations are less likely to be offered access or enroll in patient portals, which may have led to underrepresentation in the study.
“minority populations are less likely to be offered access or enroll in patient portals, 36 which may have led to underrepresentation in the current study.”
From Wearable Devices, Health Care Use, and Psychological Well-Being in Patients With Atrial Fibrillation (2024) · cites this paper as [36]
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Digital inclusion as a social determinant of health
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“We also recognize that minority populations are less likely to be offered access or enroll in patient portals, 36 which may have led to underrepresentation in the current study.”
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- Authors
- Grossman, L. V., Masterson Creber, R. M., Benda, N. C., Wright, D., Vawdrey, D. K., & Ancker, J. S.
- Affiliations
- Department of Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Department of Healthcare Policy & Research, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine (US)
- NewYork–Presbyterian Hospital (US)
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-04-08
- Volume
- 26
- Issue
- 8-9
- Pages
- 855-870
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC6696508
- OpenAlex
- W2936211750
- Cited by
- 251
- References
- 146
- Citations by year
- 2026: 29 · 2025: 37 · 2024: 44 · 2023: 38 · 2022: 44 · 2021: 35 · 2020: 18 · 2019: 4 · 2017: 1
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Library of Medicine (R01LM012964, T15LM007079)
- National Institute of Nursing Research (R00NR016275)
- Healthcare Research and Quality (R01HS21816)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Social Sciences › Demography › Technology Use by Older Adults
- Keywords
- patient portals, vulnerable populations, health disparities, intervention, SEIPS model, health information technology adoption, individual interventions
- MeSH terms
- Patient Portals, Adult, Aged, Female, Humans, Male, Middle Aged, Patient Education as Topic, Patient Access to Records, Vulnerable Populations, Health Records, Personal, Health Literacy, Digital Divide
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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