Judith H. Hibbard, Dr.P.H., and Jessica Greene, Ph.D.
Primary care practices are increasingly using Web-based portals to provide patients with information about their care, offer them with a secure communication channel with their clinicians, and facilitate appointment scheduling or prescription renewals. This Commonwealth Fund–supported study investigated the common assumption that such online access can engage patients and encourage them to take active roles in their health and care.
The researchers examined Patient Activation Measure (PAM) scores among 16,357 patients receiving primary care services in a large health care delivery system. They then examined how the PAM scores related to two other factors: 1) whether patients received a recommendation to use the patient portal, and 2) their actual patient portal use. The 13-question PAM instrument assesses the degree to which patients understand their role in their own care and have the knowledge, skills, and confidence required to take it on.
The study found that patients who are more activated are significantly more likely to be referred by their primary care provider (or other primary care team member) to use MyChart, the delivery system's patient portal, and more likely to use it. Higher-income patients were more likely to be referred to MyChart and more likely to use it. Patients with chronic conditions were also more likely to be referred to the portal, but they were no more likely than other patients to actually use it.
In this analysis, clinicians were more likely to recommend the portal to more activated patients. The authors note that it is not possible to determine whether the observed relationships are causal—if using the patient portal causes greater activation, or if activated patients are more likely to be encouraged to use it. Longitudinal studies are necessary for accurately assessing the influence of portal use on patient outcomes.