Use of Electronic Patient Portals in Orthopaedic Conditions
Varady et al. studied all patients undergoing an orthopedic surgical procedure between May 2015 and December 2018 at two academic medical centers that were part of an integrated hospital system. Patient demographic characteristics, satisfaction scores, and patient reported outcome measures (PROMs) were obtained. Multivariate logistic regression was used to identify disparities in EPP use. Adjusted logistic and linear regressions were used to assess the association between EPP use and related outcome metrics while controlling for confounders identified in the previous analysis.
The results showed that numerous demographic factors were independently associated with EPP use among patients undergoing orthopedic surgical procedures. Comparisons included English speakers versus non-English speakers, African-American or black race and Hispanic race versus white race, college education versus high school education, and a surgical procedure for orthopaedic trauma versus one for the hand or upper extremity. Interestingly, EPP use was independently associated with the increased likelihood of completing a satisfaction survey and a PROM. In addition, EPP use was independently associated with lower mean no-show rates. The lower no-show rates for EPP users corresponded to a large savings (over $218,000) in the first year after surgery.
This study identified significant disparities in EPP use by orthopaedic patients. Since EPP use is independently associated with lower no-show rates and improved patient satisfaction their use by healthcare systems to improve communication between providers and patients should be associated with efforts to reduce these disparities.
Varady et al., J. Bone Joint Surg.,1336-1343, 2020