title: Internet portal use in an academic multiple sclerosis center.
abstract: OBJECTIVE
  To evaluate the use of a secure internet portal in an academic Multiple Sclerosis (MS) Center.
  
  
  METHODS
  Retrospective case-control chart review of 240 patients during the years 2008 and 2009. Patient demographic and clinical information was extracted from our online medical records, and portal use metrics were provided by Information Systems. Descriptive statistics were utilized to explore characteristics of portal users, how the portal is used, and what associations exist between medical resource utilization and active portal use. Logistic regression identified independent patient predictors and barriers to portal use.
  
  
  RESULTS
  Portal users tended to be young professionals with minimal physical disability. The most frequently used portal feature was secure patient-physician messaging. Message content largely consisted of requests for medications or refills in addition to self-reported side effects. Independent predictors and barriers of portal use include the number of medications prescribed by our staff (OR 1.69, p<0.0001), Caucasian ethnicity (OR 5.04, p=0.007), arm and hand disability (OR 0.23, p=0.01), and impaired vision (OR 0.31, p=0.01). Discussion MS patients use the internet in a greater proportion than the general US population, yet physical disability limits their access. Technological adaptations such as voice-activated commands and easy font-size adjustment may help patients overcome these barriers.
  
  
  CONCLUSIONS
  Future research should explore the influence of portal technology on healthcare resource utilization and cost. Additional emedicine applications could be linked to the patient portal for disease monitoring and prospective investigation.
authors.affiliation: Department of Neurology, Section of Demyelinating Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. anielsen@bidmc.harvard.edu
authors.forename: A Scott
authors.initials: AS
authors.lastname: Nielsen
authors.forename: John D
authors.initials: JD
authors.lastname: Halamka
authors.forename: R Philip
authors.initials: RP
authors.lastname: Kinkel
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D057286:Electronic Health Records; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008485:Medical Audit; D008875:Middle Aged; D009103:Multiple Sclerosis; D012189:Retrospective Studies