Summary
Background: Patient portal adoption has increased over the last two decades. Most research about
patient portals has focused on adult populations in the primary care and medical specialty
settings.
Objective: We describe initial and long-term portal use by pediatric patients and their caregivers
in a broadly deployed patient portal at an academic medical center.
Methods: We analyzed portal usage for pediatric patients and their caregivers from 2008 to
2014. We recorded usage events with time stamps; user role defined as self, surrogate
(i.e., parent or guardian), or delegate; and functions accessed. Usage events were
grouped into sessions to calculate descriptive statistics by patient age, user role,
and active use over time.
Results: From 2008 to 2014, the number of portal accounts increased from 633 to 17,128. 15.9%
of pediatric patients had their own account; 93.6%, a surrogate account; and 2.2%
a delegate account. During the study period, 15,711 unique users initiated 493,753
sessions and accessed 1,491,237 functions. Most commonly used functions were secure
messaging (accessed in 309,204 sessions; 62.6%); test results (174,239; 35.3%) and
appointments (104,830; 21.2%). Function usage was greatest for patients ages 0-2 years
(136,245 functions accessed; 23.1%) and 15-17 years (109,241;18.5%). Surrogate users
conducted 83.2% of logins for adolescent patients. Portal accounts were actively used
for < 1 year for 9,551 patients (55.8%), 1-2 years for 2,826 patients (16.5%), 2–3
years for 1,968 patients (11.5%) and over 3 years for 2,783 patients (16.3%).
Conclusion: Pediatric patients and caregivers have avidly used messaging, test result, and appointment
functions. The majority of access was done by surrogates. Adolescent portal usage
increased with age. Most accounts for pediatric patients were only used actively for
a few years, with peak usage for patients in early childhood and late adolescence.
Citation: Steitz BD, Cronin RM, Davis SE, Yan Z, Jackson GP. Long-term Patterns of
Patient Portal Use for Pediatric Patients at an Academic Medical Center. Appl Clin
Inform 2017; 8: 779–793 https://doi.org/10.4338/ACI-2017-01-RA-0005
Keywords
Patient portal - Patient engagement - Consumer health informatics - Pediatrics - Electronic
health records and systems - Internet Portal
