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Interventions to increase patient portal use in vulnerable populations: a systematic review.

TitleInterventions to increase patient portal use in vulnerable populations: a systematic review.
Publication TypeJournal Article
Year of Publication2019
AuthorsGrossman LV, Creber RMMasterso, Benda NC, Wright D, Vawdrey DK, Ancker JS
JournalJ Am Med Inform Assoc
Volume26
Issue8-9
Pagination855-870
Date Published2019 Aug 01
ISSN1527-974X
Abstract

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.

DOI10.1093/jamia/ocz023
Alternate JournalJ Am Med Inform Assoc
PubMed ID30958532
PubMed Central IDPMC6696508
Division: 
Health Informatics
Category: 
Faculty Publication