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35 percent of patients with multiple chronic conditions do not use online portal for medical records even when registered to do so

October 8th, 2018

Story Contact: Austin Fitzgerald, 573-882-6217,

COLUMBIA, Mo. – New research from the University of Missouri has found that patients who could benefit the most from the convenience of online patient portals connected to their electronic medical records often don’t use them even after signing up for them.

In the United States, approximately 70 percent of health care spending goes toward patients with multiple chronic conditions. Many of these patients are encouraged to use electronic patient portals, which were incentivized by legislation in 2009 and allow secure internet access to electronic medical records. Researchers found that a significant portion of people who registered for electronic patient portals never logged in.

“We were troubled to see that so many patients never used the portal,” said Kimberly Powell, a post-doctoral fellow in aging, informatics and quality research at MU’s Sinclair School of Nursing. “We only looked at registered users, and registering for the portal is a two-step process that suggests a degree of commitment. The fact that many people who took the time to register never logged in to the portal indicates there is still work to be done.”

Powell and her colleague–Chelsea Deroche, assistant professor of biostatistics in MU’s School of Medicine–studied patients who were at least 45 years old, had registered for an electronic patient portal and had at least two chronic conditions. Though previous studies have measured the success of patient portals by the number of people who registered, this study looked at how many registered users actually logged in, finding that 35 percent never used the portal. There were no significant differences between registered non-users and those who did log in to the portal.

Researchers also identified several factors that influenced portal use among those who logged in. In particular, patients who were located farther from their primary care providers were more likely to use the portal, as were those diagnosed with heart failure.

“The importance of distance from primary care providers indicates patient portals could be beneficial for people in rural or underserved areas,” Powell said. “The potential is there, but with such a high rate of non-use, it is clear that portals need to be integrated into clinical care in a meaningful way.”

Powell said patient portals have the potential to improve shared decision-making in care facilities such as nursing homes, but providers must first integrate portals more seamlessly into clinical care and help guide patients in how to use them.

The study, “Predictors and patterns of portal use in patients with multiple chronic conditions,” is forthcoming in Chronic Illness.