On the Effect of Electronic Patient Portal on Primary Care Utilization and Appointment Adherence

Overview

Journal BMC Med Inform Decis Mak

Publisher Biomed Central

Specialty Medical Informatics

Date 2018 Oct 18

PMID 30326876

Citations 24

Authors

Xiang Zhong

Muxuan Liang

Reynerio Sanchez

Menggang Yu

Pamela R Budd

Julie L Sprague

Marvin A Dewar

Affiliations

Soon will be listed here.

Abstract

Background: The objective of this study was to investigate the impact of patient portal adoption on patients' primary care utilization and appointment adherence.

Methods: We conducted a retrospective observational study using a panel difference-in-differences (DID) framework to investigate the use of primary care services by patients, adjusting for their disease burden and allowing for time-dependent portal effect. A large dataset with 46,544 patients of University of Florida (UF) Health during the study period July 2013 - June 2016 was used. The main outcome measures are disease burden adjusted rates of office visits arrived, no-show, and cancellation to primary care physicians (PCPs) per quarter between patient portal adopters (denoted as users) and non-users.

Results: At the time of adoption, the quarterly PCP office visit rate ratio (RR) of patient portal users to non-users was 1.33 (95% CI, 1.27-1.39; p < 0.001). The RRs were between 0.94 to 0.99 up to four quarters after portal adoption (p = 0.749, 0.100, 0.131, and 0.091, respectively), and were significantly less than one at the seventh (RR =0.82; 95% CI, 0.73-0.91; p < 0.001) and the eighth (RR = 0.80; 95% CI, 0.70-0.90; p < 0.001) quarters post adoption. The quarterly no-show rates of the users were significantly smaller (RRs were between 0.60 and 0.83) except for the seventh, eighth and tenth quarters post adoption. In these three quarters, the no-show rates were not significantly changed (p = 0.645, 0.295, and 0.436, respectively). Quarterly cancellation rates were not significantly affected by portal adoption (p > 0.05 for all cases).

Conclusions: Patient portal users' disease burden adjusted PCP office visit rate was significantly reduced in one and a half year and thereafter post portal adoption. PCP appointment no-show rate was also significantly reduced and cancellation rate was not affected, implying improved care engagement of patients.

Citing Articles

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Walker J, Staab E, Ridgway J, Schmitt J, Franco M, Hunter S Int J Environ Res Public Health. 2024; 21(6).

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Self-Efficacy in Patients With Hypertension and Their Perceived Usage of Patient Portals.

Lim W, Koh Y, Tan Z, Tan Y, Tan N J Prim Care Community Health. 2024; 15:21501319231224253.

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Electronic Patient Portal Use Among People Living With HIV.

Hall A, Devlin S, Won J, Schmitt J, Ridgway J J Med Internet Res. 2023; 25:e47740.

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Lau-Min K, Bleznuck J, Wollack C, McKenna D, Long J, Hubert A JCO Clin Cancer Inform. 2023; 7:e2300024.

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