Use of Patient Portals of Electronic Health Records Remains Low From 2014 to 2018: Results From a National Survey and Policy Implications

Purpose: To investigate the trend of patient portal use in the general population and the barriers to adoption. Participants: We analyzed 3 iterations of the Health Information National Trends Survey (HINTS) collected in 2014, 2017, and 2018. Measures: Patient portal use, high-speed Internet access, data safety confidence, prior experience of online patient provider communication (OPPC), and demographic variables. Analysis: Logistic regression analyses were conducted separately for the 3 iterations of HINTS. Results: The use of patient portals increased from 25.6% in 2014 to 30.5% in 2017, and 31.4% in 2018. These users were more likely to be white female with higher levels of education or income. Meanwhile, high-speed Internet access, prior experience of OPPC, and data safety confidence were positive predictors of patient portal use in all 3 iterations. Conclusion: The use of patient portals in the general public remains low and a significant digital divide persists, presenting a major challenge on meaningful use of electronic health record. We call for more effective interventions to address these gaps. Such interventions should target people of low socioeconomic status and focus on improving eHealth literacy and patients' confidence in data safety.