186 - Characteristics of Patient Portal Usage by Pediatric Emergency Patients

Poster Number: 186
Publication Number: 186.1813

Background: Disparities in usage of patient portals are well-demonstrated in studies of adult patient populations. Users differ from non-users with respect to sociodemographics and characteristics of emergency department (ED) utilization. These findings may not be generalizable to patients of pediatric EDs where differences include caregiver proxy access to a minor’s information and considerations related to confidential healthcare for minors. Characteristics of portal usage by pediatric emergency patients and their caregivers have not yet been described.

Objective: To describe sociodemographic and ED encounter characteristics of the most and least active patient portal users in the pediatric ED population and to evaluate types of portal functions most commonly used.

Design/Methods: We performed a single-center retrospective analysis on patients who presented to a pediatric ED. Patients from birth to 21 years of age with an ED encounter in the electronic health record from September 1, 2020 to May 22, 2022 were included. Patients 22 years of age and older were excluded.
Those with activated portals were defined as users. Logins for users were counted and the top 75th percentile were used to define active users based on methodology in prior studies. Patient and encounter characteristics were compared amongst users and active users. Usage of specific portal functions was analyzed.

Results: In total, 71,004 patient encounters were analyzed. 29,881 patients were found to be users, 36.2% of these were active users. Higher number of ED visits during the study period was associated with active user status (Phi 0.325, p < 0.001, 95% CI 0.149, 0.211). High level of usage was also associated with self-reported race of “Other” or “Unknown” (OR 1.846, p < 0.001 and OR 2.441, p < 0.001 respectively) and Hispanic ethnicity (OR 1.247, p < 0.001). Portals for patients under 2 years of age had the highest proportion of active users (47.7%) as compared to other age groups. Low-usage was associated with discharge from the ED (OR 0.836, p < 0.001), patient male sex (OR 0.880, p < 0.001) and non-English primary language (OR 0.666, p < 0.001). The most used portal function during ED visits was viewing of lab and imaging results.

Conclusion(s): We identified significant patient-level and encounter-level differences between most and least active portal users in the pediatric ED. Future efforts can be tailored to understand and increase engagement of under-active groups. Study limitations include lack of information on self-reported race groups and delineation of proxy versus patient access of adolescent patient portals.