Patient Engagement in Patient Portals in Appalachia v. Surrounding U.S. Census Regions: An Analysis of HINTS (Health Information National Trends Survey) Data, 2017–2020

INTRODUCTION: Those living in the Appalachian Region face a greater number of significant health disparities than residents of other areas of the U.S. Patient portals can decrease disparities, increase health literacy, and improve health outcomes. PURPOSE: This study explores if those living in the Appalachian Region are offered access to and use their patient portals differently than those in the surrounding U.S. Census regions. Additionally, the study aims to determine if there was a difference in reported reasons for the non-use of patient portals. METHODS: A secondary analysis was completed using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) (2017–2020), a nationally representative survey. Descriptive statistics and chi-square tests were used to determine differences in patient portal use between regions. RESULTS: There was no statistically significant difference between the Appalachian and surrounding U.S. Census regions in being offered access to patient portals. However, there was a statistically significant difference (non-weighted) between regions in the use of patient portals. Common reasons for the non-use of patient portals were a preference to speak directly to the provider and the lack of perceived need to use the portal. IMPLICATIONS: Providers in the Appalachian Region should be aware of the non-use of patient portals. Moreover, understanding the reported reasons for non-use may help providers tailor educational materials to increase patient portal use.