title: Patient Portals: Who uses them? What features do they use? And do they reduce hospital readmissions?
abstract: Patient portals have demonstrated numerous benefits including improved patient-provider communication, patient satisfaction with care, and patient engagement. Recent literature has begun to illustrate how patients use selected portal features and an association between portal usage and improved clinical outcomes.
  
  
  
  This study sought to: (1) identify patient characteristics associated with the use of a patient portal; (2) determine the frequency with which common patient portal features are used; and (3) examine whether the level of patient portal use (non-users, light users, active users) is associated with 30-day hospital readmission.
  
  
  
  My UNC Chart is the patient portal for the UNC Health Care System. We identified adults discharged from three UNC Health Care hospitals with acute myocardial infarction, congestive heart failure, or pneumonia and classified them as active, light, or non-users of My UNC Chart. Multivariable analyses were conducted to compare across user groups; logistic regression was used to predict whether patient portal use was associated with 30-day readmission.
  
  
  
  Of 2,975 eligible patients, 83.4% were non-users; 8.6% were light users; and 8.0% were active users of My UNC Chart. The messaging feature was used most often. For patients who were active users, the odds of being readmitted within 30 days was 66% greater than patients who were non-users (p<0.05). There was no difference in 30-day readmission between non-users and light users.
  
  
  
  The vast majority of patients who were given an access code for My UNC Chart did not use it within 30 days of discharge. Of those who used the portal, active users had a higher odds of being readmitted within 30 days. Health care systems should consider strategies to: (1) increase overall use of patient portals and (2) target patients with the highest comorbidity scores to reduce hospital readmissions.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , 135 Dauer Drive, Chapel Hill, NC 27599.
authors.forename: Ashley
authors.initials: A
authors.lastname: Griffin
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , 135 Dauer Drive, Chapel Hill, NC 27599.
authors.forename: Asheley
authors.initials: A
authors.lastname: Skinner
authors.affiliation: Learning and Diffusion Group, Center for Medicare and Medicaid Innovation , 7500 Security Boulevard, Baltimore, MD 21244.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Thornhill
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599; Center for Health Services Research in Primary Care, Department of Veterans Affairs, Durham NC 27705.
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D000072638:Patient Portals / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000628:therapy
keywords: Electronic health records and systems; meaningful use; patient portal; patient-provider; personal health records