Unlock Your Health: Are Patient Portals Leaving Some Behind?
"Discover the surprising disparities in patient portal adoption and how to bridge the digital divide for better healthcare access."
In today's rapidly evolving healthcare landscape, patient portals have emerged as a powerful tool, offering individuals secure online access to their medical records, test results, and direct communication with healthcare providers. These platforms hold the potential to revolutionize patient engagement, improve adherence to treatment plans, and reduce unnecessary healthcare utilization.
However, the promise of patient portals hinges on equitable access and widespread adoption. While a significant portion of the population embraces these digital tools, disparities persist, leaving certain groups behind and potentially exacerbating existing health inequities. Understanding who isn't using patient portals and why is crucial for bridging the digital divide and ensuring that everyone benefits from this transformative technology.
A recent study delved into this critical issue, analyzing data from a nationally representative sample of U.S. adults to identify the characteristics of patient portal non-users and explore the reasons behind their reluctance. The findings shed light on the key barriers to adoption and offer valuable insights for policymakers, healthcare providers, and technology developers seeking to promote equitable access and maximize the potential of patient portals.
Portal Access and Use
The Office of the National Coordinator for Health Information Technology documented individuals’ use of online medical records and patient portals to view, download, or transmit information from 2020 through 2022. Its 2024 Health Information National Trends Survey brief uses the latest HINTS data to assess progress in patient and caregiver access after implementation of Cures Rule provisions. Healthcare app coverage also identifies adoption, usage frequency, features, and barriers as central measures of digital-care access.
Benefits Require Safeguards
Patient portals give patients access to health information directly from electronic health records in hospitals, primary care centres, and general practices. They can support communication with healthcare providers and care coordination, but systematic-review evidence says their effects on individual health and health-system efficiency remain unclear. Research on digital-health adoption warns that moving from analogue to digital care can create digital inequalities without mitigation strategies. Interoperability also requires organisational, individual, technical, and interorganisational factors, including standards for consent and information sharing.
From Digital Tools to Portals
The history of digital health includes devices and technologies developed after the telegraph, photophone, and radio, along with their applications in healthcare delivery. More recent historical work traces milestones in digital tools and artificial intelligence, including the emergence of generative artificial intelligence. The introduction of online patient portals marked a major step in digital patient access by allowing patients to view medical records, schedule appointments, and communicate with providers online.
The Digital Divide: Who's Missing Out on Patient Portals?
The study revealed a significant gap in patient portal adoption, with 63% of insured adults reporting that they had not used a portal in the past year. This highlights the urgent need to address the underlying factors contributing to this disparity.
- Gender: Men were more likely than women to be non-users.
- Insurance Type: Individuals on Medicaid were less likely to use portals compared to those with private insurance.
- Education Level: Those with less than a college education were more likely to be non-users.
- Healthcare Access: Lack of a regular healthcare provider was a significant barrier to portal adoption.
- Race/Ethnicity: Non-white individuals were less likely to report being offered access to a portal.
Evidence of Unequal Use
A cross-sectional study examined portal activation disparities among 72,417 patients with at least one outpatient neurology encounter, including telehealth, at two academic medical centers in Washington, DC. A separate patient-engagement study reported that higher education, female gender, Caucasian ethnicity, internet access, higher income, non-Medicaid insurance, and trust in the healthcare provider and system were associated with higher portal use. Research on adolescent access found that automatic portal deactivation at age 13 reduced portal access among adolescent patients. These findings point to differences associated with geography, socioeconomic conditions, trust, and age-related account policies.
The Engagement Gap
A 2025 scoping review examined perceived gaps and challenges patients face when using digital technology. Its starting point is that technological growth creates opportunities but also issues that can limit patient use. A review of healthcare patient portal usage describes portals as web-based personal health records linked to electronic health records that provide information access and communication, while also cataloguing benefits, issues, challenges, and possible rectifications. This suggests that offering portal functions alone does not resolve usability, access, or implementation problems.
Comparing Portal Tools
Current comparison resources evaluate electronic health record patient portals by usage statistics, features, and cost. One 2026 comparison identifies Epic MyChart and InteliChart among the tools assessed and describes workflows involving scheduling, messaging, forms, and secure results. Other software guides define patient portals as secure web applications offering 24/7 access to personal health information and self-service functions such as scheduling and bill payment. Product listings also include Luma Health, Epic MyChart, and Solutionreach, showing that comparisons span both capabilities and vendors.
Bridging the Gap: Strategies for Equitable Access
The study underscores the importance of a multi-faceted approach to promote equitable patient portal adoption. By addressing these key barriers and implementing targeted interventions, we can bridge the digital divide and ensure that all individuals have the opportunity to benefit from the transformative potential of patient portals. This will require more education as well as technological designs that enable patients to communicate with providers in acceptable ways.
Trust and Digital Growth
Forecast-oriented coverage of medical patient portals in 2026 focuses on digital access, communication, patient engagement capabilities, and healthcare workflows. Future-trend analysis identifies enhanced data security as a way to strengthen patient trust and confidence in portal security, which can encourage adoption and use of digital-health engagement services. Market coverage also highlights adoption trends, growth drivers, challenges, and future forecasts. In the United States, regulatory support for electronic health records and patient-engagement tools is described as a factor benefiting the patient portal market.
Digital Inequality in Care
Research connected to the NHS 10-Year Plan examines digital health apps and patient portals as part of a shift from analogue to digital care. The study warns that digital inequalities could arise without mitigation strategies and states that more evidence is needed to understand how those inequalities can be addressed. Its equality-impact framing treats adoption as a system-level issue rather than only a matter of individual preference. This makes implementation and mitigation central to whether digital care expands access or leaves some people behind.
Learning from Implementation
The Stanford Mussallem Center for Biodesign presents digital-health case studies for examining the issues, challenges, and opportunities companies face when identifying, inventing, and implementing new health technologies. The American Medical Association describes case studies as a way to show what is working and identify gaps and opportunities for optimization in digitally enabled care. Its examples highlight collaborations between health systems or physician practices and digital-health companies. A separate collection reports that user-centered portal design, adoption efforts, and continuous evaluation can support patient engagement, care coordination, and health outcomes.