Unequal Access and Differential Use of Patient Portals: Analysis of HINTS 7 Data

Patient portal use has been linked to increased patient engagement, improved relationships with healthcare providers, and higher patient satisfaction. The current study aimed to contribute to patient portal research by proposing the breadth of functions utilized and the breadth of healthcare entities connected as two novel ways to conceptualize and operationalize patient portal use, updating the research on the disparities in patient portal access, and examining differentiated use of patient portals beyond the dichotomy of access vs no access. We analyzed Health Information National Trends Survey (HINTS) 7 data with the full-sample person weights and replicate weights. More than two-thirds of the U.S. adult population had patient portal access, but the vast majority of them accessed patient portals less than once every two months on average. Making appointments, messaging providers, looking up test results, and viewing clinical notes were used by more than half of the U.S. adult population. Primary care providers were the most widely connected entities, with other providers, insurers, clinical labs, pharmacies, and hospitals showing a low level of connection to patients via portals. In the United States, both unequal access and differentiated use exist between sociodemographic groups, highlighting the need for continued monitoring and concerted efforts to address them. At the same time, a close examination of the factors that led to the higher access rates and beneficial uses by traditionally disadvantaged groups-women and people with poorer health-could offer effective strategies to close the gaps.