Patient portal 'techquity' elusive, digital divide remains

There are still patient portal haves and have-nots, with new data in the American Journal of Managed Care showing that patients who are over age 65, men, non-White and non-English speakers are less likely to use the technology than their peers.

These findings, presented by researchers from M Health Fairview in Minnesota, show that the healthcare industry still hasn't delivered on techquity, or the idea that every person would have an equal opportunity to make use of leading digital health tools.

Patient portals are key patient engagement tools, most experts agree. The technology enables patients to access their own medical records as well as securely message their providers, request appointments, request prescription refills and generally coordinate their own care. Patient portals have been linked to better primary and preventive care access, plus fewer patient no-shows.

Nearly every healthcare organization offers patient portal access, and the rates of patient adoption continue to rise.

But, according to this most recent study, patient portal utilization is not the same across patient demographics.

The researchers looked at patient portal utilization data for patients over age 50 with at least one chronic illness and who'd visited an M Health Fairview facility for any reason between 2011 and 2024. They then stratified that data by patient characteristics, including age, race and education level, among others.

Of the more than 250,000 patients with a chronic illness included in the study, 61% had activated the patient portal and 54% had logged in at least once during the study period. The researchers said these were high rates, but when stratifying by demographic, the picture becomes grim.

For example, patient portal use was only 42% among those over age 65. Use was also lower among Black people (40%), those who did not speak English (38% for Hmong-speakers, 21% among Somali-speakers and 28% among Spanish-speakers) and individuals with certain chronic conditions.

More specifically, patients with heart failure or chronic obstructive pulmonary disease were less likely to use the patient portal. By comparison, those with diabetes, neoplasms, ischemic heart disease and hypertension were more likely to engage with the technology.

The researchers stressed the risks associated with these types of health IT disparities. As patient portals become more instrumental to the healthcare experience, and especially chronic disease management, disparities in health IT use could lead to disparities in outcomes.

Healthcare organizations might consider tools that have more tailored and inclusive design, such as multilingual patient portals or those with specialized workflows. Supporting patient adoption with personalized training and assistance could also be helpful, the team said.

The problem of patient portal disparities -- and the proposed solutions to close the access gap -- are not new. In the middle of 2025, ASTP/ONC published its annual data brief showing generally widespread patient portal access and utilization but noted that use is not equal across demographics.

The ONC/ASTP report specifically flagged rural areas for patient portal use disparities, stating that small, rural, non-teaching, critical access and independent hospitals were all less likely to enable certain patient portal capabilities for patients.

But the principle remains the same. In order to ensure equitable health outcomes, industry leaders must ensure equitable access to the tools that support them. Designing patient portals for use across demographics, plus ensuring all patients are given equal opportunity to adopt them, will be critical.

Sara Heath has reported news related to patient engagement and health equity since 2015.