Evidence map›Paper›PMID 39377862›Full record

ArticleJournal of medical systems2024

Automatic Enrollment in Patient Portal Systems Mitigates the Digital Divide in Healthcare: An Interrupted Time Series Analysis of an Autoenrollment Workflow Intervention.

Leila Milanfar, William Daniel Soulsby, Nicole Ling, Julie S O'Brien, Aris Oates, Charles E McCulloch

Abstract read
In one paragraph

Article in Journal of medical systems, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Leila MilanfarSchool of Medicine, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, United States of America. leila.milanfar@ucsf.edu.ORCID https://orcid.org/0009-0003-6872-8495
William Daniel SoulsbyDepartment of Pediatrics, Division of Pediatric Rheumatology, University of California, San Francisco, San Francisco, CA, United States of America.
Nicole LingDepartment of Pediatrics, Division of Pediatric Rheumatology, University of California, San Francisco, San Francisco, CA, United States of America.
Julie S O'BrienDepartment of Pediatrics, Division of General Pediatrics, University of California, San Francisco, San Francisco, CA, United States of America.
Aris OatesDepartment of Pediatrics, Division of Pediatric Nephrology, University of California, San Francisco, San Francisco, CA, United States of America.
Charles E McCullochDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America.

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
Arthritis Foundation via a Diversity, Inclusion, and Equity Research in Health Outcomes 891767National Center for Advancing Translational Sciences, National Institutes of Health, UCSF-CTSI UL1TR001872NCATS NIH HHS UL1 TR001872
6 · The paper itself

Abstract

purposeRacial and ethnic healthcare disparities require innovative solutions. Patient portals enable online access to health records and clinician communication and are associated with improved health outcomes. Nevertheless, a digital divide in access to such portals persist, especially among people of minoritized race and non-English-speakers. This study assesses the impact of automatic enrollment (autoenrollment) on patient portal activation rates among adult patients at the University of California, San Francisco (UCSF), with a focus on disparities by race, ethnicity, and primary language. MATERIALS AND

methodsStarting March 2020, autoenrollment offers for patient portals were sent to UCSF adult patients aged 18 or older via text message. Analysis considered patient portal activation before and after the intervention, examining variations by race, ethnicity, and primary language. Descriptive statistics and an interrupted time series analysis were used to assess the intervention's impact.

resultsAutoenrollment increased patient portal activation rates among all adult patients and patients of minoritized races saw greater increases in activation rates than White patients. While initially not statistically significant, by the end of the surveillance period, we observed statistically significant increases in activation rates in Latinx (3.5-fold, p = < 0.001), Black (3.2-fold, p = 0.003), and Asian (3.1-fold, p = 0.002) patient populations when compared with White patients. Increased activation rates over time in patients with a preferred language other than English (13-fold) were also statistically significant (p = < 0.001) when compared with the increase in English preferred language patients.

conclusionAn organization-based workflow intervention that provided autoenrollment in patient portals via text message was associated with statistically significant mitigation of racial, ethnic, and language-based disparities in patient portal activation rates. Although promising, the autoenrollment intervention did not eliminate disparities in portal enrollment. More work must be done to close the digital divide in access to healthcare technology.

Indexed as

Digital DivideInterrupted Time Series AnalysisPatient PortalsAdultElectronic Health RecordsEthnicityFemaleHealthcare DisparitiesHumansLanguageMaleMiddle AgedRacial GroupsSan FranciscoText MessagingWorkflowElectronic health recordsHealthcare disparitiesHealth recordsHealth services accessibilityPersonalRace factors

Identifiers

PMID39377862
PMCPMC11461562

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.