A single-center study showed that certain cancer patients were less likely to enroll in a patient portal that allows them to access their electronic health records (EHRs). The study was published in JAMA Oncology.1
The data showed that Black patients were 44% less likely to enroll than White patients, and patients in their 80s were 36% less likely to enroll than patients aged 18 to 29 years.
The researchers tracked 266,917 patients who first visited the University of California, San Francisco (UCSF) cancer center from 2012, when the center adopted the patient portal, to 2020. The researchers analyzed patients’ self-reported demographic information, along with rates of patient sign-up and the number of days from their initial visit to portal registration.
“[Enrollment] is one of the first natural steps to look at,” in terms of understanding how patients interact with EHRs, said study author Julian C. Hong, MD, MS, assistant professor in the Department of Radiation Oncology and Bakar Computational Health Sciences Institute at UCSF.
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The researchers found that certain groups, particularly men and patients aged 18 to 29 years, had lower enrollment rates initially, but those rates eventually caught up with the higher enrollment rates observed in women and patients aged 30 to 39 years.
The groups older than 39 years took longer to enroll and never caught up with the younger groups, and enrollment decreased with increasing age, especially for patients 80 years of age and older, Dr Hong noted.
There were lower enrollment rates initially among Black patients and patients for whom English was not their primary language, when compared with White patients and native English speakers, respectively. These differences persisted throughout the study.
Other studies have described age and racial disparities in using EHRs in various patient populations, and research suggests that disparities may be more pronounced at the level of enrollment.2
An analysis of patients with cancer at an academic medical center in the southern United States showed that younger patients and White patients were more likely than other age and racial groups to engage with the portal, mostly to view test results and respond to clinic messages.3
However, a study that observed racial and age disparities among those who enrolled in the patient portal showed no racial disparities in portal use among the individuals who did enroll.4
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