Patient Portal Utilization Growing Among Older Adults

Patient portal utilization is growing among older adults, according to Michigan Medicine data, but there’s still room to close the digital divide across sociodemographics.

Over the past five years, the number of adults ages 50 to 80 who use the patient portal for patient data access increased 27 percentage points, from 51 percent to 78 percent, per the Michigan Medicine National Poll on Health Aging.

This trend comes on the heels of the COVID-19 pandemic, which pushed many patients and providers to explore the systems that would allow them to connect remotely.

In addition to telehealth, patient portals came front and center as more patients checked COVID-19 test results and generally took greater control over their own health and well-being, according to Denise Anthony, a professor and chair of the Department of Health and Management Policy at the School of Public Health at the University of Michigan.

“This change makes access to secure portals even more important for older adults who want to see their doctors and other health care providers virtually. It also makes the disparities we found in our poll even more troubling,” Anthony, who worked on the poll and studies use of telehealth and patient portals, said in a statement.

“Improving the functionality and accessibility of portal systems, as well as providing more outreach and training to help patients understand and use portal systems, will be crucial to improving equity,” added Anthony, who is also a professor of sociology in LSA and a professor of information in Michigan’s School of Information.

Notably, older adults are using some of the proxy functions within the patient portal. Patient portal proxy access allows a loved one or another designated caregiver to look at the patient portal. This function is useful for older adults who are under the care of a spouse or adult child.

The Michigan Medicine poll found that 49 percent of users have granted proxy patient portal access to someone else, up from 43 percent who did the same in 2018. For 40 percent of patient portal users, proxy access has been granted to a spouse or partner; 48 percent of men have granted proxy access compared to 32 percent of women.

These findings are notable given the benefits patient portal utilization can have on patient engagement, according to Jeffrey Kullgren, associate professor of internal medicine at Michigan Medicine and a physician and researcher at the VA Ann Arbor Healthcare System.

“A growing body of evidence shows that patients who use portals to access their information are more likely to take an active role in their care and stick to the treatment plan their physicians and other providers recommend, which we know is likely to lead to better outcomes,” Kullgren said in a press release.

Moreover, some researchers previously indicated that older adults could be more reticent to use the patient portal. That notion has since been shown to be a myth, plus the older population is increasingly natively comfortable with technology.

However, despite rising patient portal utilization rates among older adults, there are some disparities, the survey showed.

Older adults with incomes below $60,000 annually, plus Black and Hispanic older adults, have lower patient portal utilization rates than their high-income and White peers. These groups were also less likely to say they are comfortable using the patient portal compared to high-income or White people.

Additionally, populations who self-reported fair or poor physical or mental health were more likely to say they were not confident using patient portal technology—particularly their ability to log in and navigate the tool—compared to other poll respondents with better self-reported health.

Moreover, even folks who said they liked using the patient portal for patient data access still preferred using the phone for other tasks, like appointment scheduling and speaking with a clinician.

The researchers suggested it might be fruitful for healthcare organizations to provide some patient portal training for patients.

“Health care organizations that offer portals and providers working in those organizations should make an effort to engage and support patients who have not yet activated a portal account and offer training to increase confidence and encourage the sharing of access with trusted loved ones,” Kullgren advised. “This is especially important for patients who have complex health needs or multiple conditions.”

The poll showed that around a quarter (27 percent) of patients—even those who currently use the patient portal—want to learn more about how to use the technology. This desire was more prominent among those with household incomes below $60,000, those who are Hispanic or Black, or those who have not used the patient portal in a while.

Of course, there are some barriers to patient portal utilization that go beyond the scope of patient comfort and know-how. Issues like broadband access disproportionately affect low-income folks living in rural areas. Advocating for better broadband must be part of clinicians’ efforts to close the digital divide, according to Indira Venkat, AARP senior vice president of research.

“Research shows that while more older Americans are embracing technology, nearly 22 million seniors still do not have wireline broadband access at home, limiting their access to essential digital health care services like patient portals,” Venkat said in the press release. “Closing the digital divide among older adults is critical to improving their wellbeing, especially for vulnerable communities and individuals.”