Digital divide persists with online portals for cancer patients

(Reuters Health) - Even as a growing number of cancer patients are setting up accounts for online access to medical charts, fewer people are actually logging on to look at their test results, a U.S. study suggests.

For the study, researchers examined data on 44,590 cancer patients treated between 2007 and 2016, including 19,434 who set up online MyChart accounts to get remote access to their records.

During this decade, the proportion of patients with MyChart accounts rose from 26 percent to 62 percent, researchers report in JAMA Oncology.

In recent years, however, the number of people checking their test results online declined, from 61 percent in 2012 to 38 percent by the end of the study.

Black patients, meanwhile, were half as likely to check test results as white people, and Spanish speakers were 63 percent less likely than English speakers to look online at their results.

“Internet access is not uniform across populations,” said senior study author Dr. David Gerber, a researcher at the University of Texas Southwestern Medical Center in Dallas.

“There exists a `digital divide,’ with certain groups having lower access to broadband Internet than others,” Gerber said by email.

The sheer volume of information in recent years may be overwhelming patients and discouraging them from using these portals, Gerber said.

“Over the past few years, the number of test results released on the portal has increased markedly,” Gerber added. “While the number of results viewed has also increased, it has not kept pace with the number of results released.”

All of the patients in the study were treated at the Harold C. Simmons Comprehensive Cancer Center at the University of Texas Southwestern Medical Center.

Half of them were at least 64 years old, and three out of four were white.

It’s possible that socioeconomic status might have influenced whether people set up patient portal accounts or used them, but the study didn’t include people without insurance, researchers note.

While results from patients at a single cancer center in Texas might not reflect what would happen everywhere, the findings do suggest that doctors should consider the possibility that information communicated via online portals may not necessarily reach patients, the authors conclude.

Particularly for nonwhite or non-English speakers, this means the portals may not have the intended effect of making medical information more transparent and supporting shared decision making between doctors and patients.

“Cancer patients presumably are focused on being healthy, and the patient portal is meant to allow patients to engage deeply in managing their health through looking at results and communicating with their providers,” said Dr. Mita Sanghavi Goel, a researcher at the Feinberg School of Medicine at Northwestern University in Chicago who wasn’t involved in the study.

“This study was surprising because it found that there was a trend towards looking at fewer test results over time, even among cancer patients,” Goel said by email. “It raises the question, then, that if cancer patients are less likely to look at their results over time, who would?”

SOURCE: JAMA Oncology, online January 25, 2018.