Vienna family medicine portal12/2/2023 ![]() We used structured query language to extract data from the EHR. ![]() We herein use “pediatric portal use” to denote either proxy or adolescent use unless otherwise specified. Parent proxies and adolescents are offered portal enrollment at clinical visits. The portal includes features such as secure messaging with the healthcare team viewing laboratory and imaging results requesting prescription refills viewing immunization records, visit summaries, and upcoming appointments requesting for release of information and accessing educational materials. Adolescents 12-17 years of age may obtain full access and the parent or guardian can request limited proxy access. Parents or guardians of pediatric patients can obtain proxy access for children under 12 years of age. These included 6 pediatric, 6 medicine-pediatrics, and 4 family medicine practices, all using one EHR (Epic Systems, Verona, WI). We analyzed data from the EHR and patient portal for the 1-year time period August 1, 2017, to July 31, 2018, for children attending 1 of 16 primary care practices within the University of California, Los Angeles Health System. This study was approved by the institutional review board at the University of California, Los Angeles. The objectives of this study were to assess, for pediatric primary care patients in one large health system in which most patients are insured and have access to primary care: (1) characteristics of active users, nonactive users (who activated a portal account but have not used the portal), and nonusers (2) patterns of adolescent and their proxy portal use and (3) practice variations in pediatric portal use. One way to assess variations in pediatric portal use is to examine utilization throughout a health system so that variations are likely due to patient or provider factors rather than technical, health system, or community-based factors. 10, 11 Better understanding of pediatric and adolescent portal use will help health system leaders meet patient needs. Further, little is known about variations in pediatric portal among children, adolescent self-use of the portal, or variations across pediatric providers. Most studies of pediatric portal utilization have relied on parent-reported use and perceptions rather than portal-based metrics. 10 However, this study included both primary care and subspecialty patients, and the authors highlighted the need for examining pediatric portal use in primary care populations. 8, 9 A study from one institution assessed pediatric portal usage between 20 and noted rapid uptake, substantial use by parents or guardians, and moderate use by older adolescents. 6 A few pediatric studies have noted a positive association between portal use and higher treatment engagement 7 and improved communication between parents and health providers 8 and among health providers. A 2014 systematic review noted high parental satisfaction with the concept of the portal, yet only scant evidence for improvement in quality of care due to the portal. 2–5Įven less is known about pediatric portal use, including activation (ie, signing up for the portal), frequency of use, types of services used, or impact on quality or outcomes. 1 Variations exist: studies, mostly on adults, have noted that patients with lower socioeconomic status, with lower health literacy, and of minority backgrounds are less likely to use the portal. 1 A recent online national survey of insured adults found that among those with a healthcare visit in the past year, 37% had used the portal within 12 months. Patient portal use has grown tremendously. The patient portal, an online service or website that connects the patient to the electronic health record (EHR), can support this goal via 2-way communication with healthcare providers, access to upcoming appointments and to laboratory information, billing, prescription refill requests, medication and problem lists, and health summaries such as vaccination dates. A goal for most health systems is to engage patients in their own health care.
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