Primary care doctors, nurses play significant role in increasing use of online patient portals

Older patients are managing health care online more than expected

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Integrating promotion of online patient portals into primary care visits appears to be the most effective way to increase usage of the portals, according to a Virginia Commonwealth University-led study published this month in the Annals of Family Medicine. Researchers also found that one out of three patients aged 60-69 utilized the portals – the highest rate of any age group studied.

“While patient portals can help to engage patients in their care and even lead to improved health outcomes, getting patients online has been difficult,” said Alex Krist, M.D., associate professor in the Department of Family Medicine and Population Health, VCU School of Medicine. “However, primary care practices can effectively encourage their patients to use a portal by making promotion of the portal part of routine care.”

Critics of patient portals express concerns that online technologies might discriminate against older patients, but findings in the 60- to 69-year-old age group suggest otherwise.

“Older patients (60-69) were more likely to get online,” Krist said. “This seems like it was driven by the fact that they were more likely to have a chronic condition and more likely to have a need for health information, but it is still a finding counter to many people’s concern that older people won’t get online.”

With the continued push to engage patients in care through the use of information technology, researchers examined cost-effective ways small- to medium-sized primary care practices can effectively encourage patients to use online patient portals to access their personal health records.

Analyzing data from eight Virginia primary care practices, they find that integrating promotion of the portal into the office visit (via doctors and nurses) appears to be more effective at increasing usage rates than mailing invitations and other costly advertising campaigns used at large integrated systems.

Specifically, the researchers found that during the 30-month study period, 26 percent of the 112,893 patients who had an office visit created an account on the patient portal. Of patients who visited the practices in the final month, 33 percent had a new or preexisting account. The authors point out that this uptake was significantly greater than the 17 percent observed in a previously conducted efficacy trial, in which the portal was only promoted through mailings.

The VCU Department of Family Medicine and Population Health created the portal (called MyPreventativeCare) that the study practices fielded. The research was funded through a series of grants including three from the Agency for Healthcare Research and Quality, and the VCU Center for Clinical and Translational Research funded and supported the research analysis.