Understanding the demographic characteristics of personal health record users in an integrated healthcare organization

Background: The revolution in healthcare occurring in the past decade has had at its center a host of electronic healthcare services. Paramount among them is the personal health record (PHR). PHRs help patients communicate with providers, access their health information, and conduct clinical transactions. PHR use has been said to result in increased patient health engagement, improved disease management and enhanced patient-provider relationships. However, these benefits may disproportionately accrue to populations with the resources and skills necessary for online engagement. This study presents a detailed analysis of the demographic factors associated with PHR use among patients of a large integrated healthcare organization. Objectives: 1) To investigate the demographic characteristics of patients who use the PHR. 2) To compare the characteristics of PHR users to the organization's total patient population. 3) To determine where e-health disparities may exist. Methods: Data are from Kaiser Permanente's patient and website databases. Demographic and PHR utilization information on all adult patients was used in a retrospective data analysis. Results: The three most frequently used PHR features were: online lab test results, physician email, and online prescription refills. Non-white patients were less likely than white patients to be registered for the PHR. Women were more likely than men to use each of the features. Older patients were more likely than younger patients to use the PHR and were the most frequent PHR users. Hispanic patients were less likely than patients of any other racial/ethnic group to use the PHR. Discussion: We found support for a digital divide across racial/ethnic groups. Not only were Hispanic patients less likely than others to register for the PHR, those who were registered were less likely to use the PHR. The most prominent difference was in the use of physician-patient email. Language skill is a potential barrier to PHR use.