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Submitted on March 16, 2005
Accepted on September 2, 2005
Affiliation of the authors: 1 Stoneman Center for Quality Improvement, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA; Center for Patient Safety, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; 2 Stoneman Center for Quality Improvement, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; 3 Stoneman Center for Quality Improvement, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; ZixCorp, Dallas, TX
* To whom correspondence should be addressed.
Objective Although the patient Internet portal is a potentially transformative technology, there is little scientific information about the demographic and clinical characteristics of portal enrollees, and the features that they access.
Design We describe two pilot studies of a comprehensive Internet portal called PatientSite. These pilots include a prospective one-year cohort study of all patients who enrolled in April 2003, and a case-control study in 2004 of enrollees and non-enrollees at two hospital-based primary care practices.
Measurements The cohort study tracked patient enrollment and features in the PatientSite that enrollees accessed, such as laboratory and radiology results, prescription renewals, appointment requests, managed care referrals, and clinical messaging. The case-control study used medical record review to compare the demographic and clinical characteristics of 100 randomly selected PatientSite enrollees and 100 non-enrollees.
Results PatientSite use grew steadily after its introduction. New enrollees logged in most frequently in the first month, but 26%-77% of the cohort continued to access the portal at least monthly. They most often examined laboratory and radiology results, and sent clinical messages to their providers. PatientSite enrollees were younger, more affluent, and had fewer medical problems than non-enrollees.
Conclusion Expanding the use of patient portals will require an understanding of obstacles that prevent access for those who might benefit most from this technology.
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