On the effect of electronic patient portal on primary care utilization and appointment adherence

Abstract

Abstract Background The objective of this study was to investigate the impact of patient portal adoption on patients’ primary care utilization and appointment adherence. Methods We conducted a retrospective observational study using a panel difference-in-differences (DID) framework to investigate the use of primary care services by patients, adjusting for their disease burden and allowing for time-dependent portal effect. A large dataset with 46,544 patients of University of Florida (UF) Health during the study period July 2013 – June 2016 was used. The main outcome measures are disease burden adjusted rates of office visits arrived, no-show, and cancellation to primary care physicians (PCPs) per quarter between patient portal adopters (denoted as users) and non-users. Results At the time of adoption, the quarterly PCP office visit rate ratio (RR) of patient portal users to non-users was 1.33 (95% CI, 1.27–1.39; p 0.05 for all cases). Conclusions Patient portal users’ disease burden adjusted PCP office visit rate was significantly reduced in one and a half year and thereafter post portal adoption. PCP appointment no-show rate was also significantly reduced and cancellation rate was not affected, implying improved care engagement of patients.

Keywords

• Patient portal
• Primary care utilization
• Appointment adherence
• Disease process
• Panel-DID
• Causal inference