Use of an EMR online portal for communication with cancer patients.

147 Background: Communication with patients about their health care is vital to the physician-patient relationship. This is especially true in oncology where patients receive frequent diagnostic evaluations and their diseases are often active and evolving. In 2009, as part of "meaningful use", Congress mandated the need to establish an electronic portal for patient communication. We studied factors associated with the use of our online patient portal.

METHODS: We performed a retrospective chart review of the use of our EMR online portal, MyChart. We assessed whether patients were informed of the existence of the portal and if they had activated and used it. We analyzed whether disparities in age, gender, rural or urban residence, or income impacted patients' use of this feature.

RESULTS: Between January 1, 2014 and December 31, 2015, 1947 patients were seen in the Hematology Oncology Clinic at St. Louis University Hospital. 508 (26.1%) had activated and used MyChart and 1437 (73.9%) had not. Of 1437 patients who had not used MyChart, 110 (7.6%) had not been given the code, 1316 (91.5%) had been given the code but had not activated it, and 13 (0.9%) had declined the code. Patients who activated MyChart were more likely to be less than 65 years old (60.0% vs 40.0% p < .0.0001). Patients who did not activate it were more likely to live in a ZIP code where the median annual income was below the state median, a surrogate for lower income (84.8% vs 15.2%, p < 0.0001). Use of MyChart was not statistically associated with gender or with residence in an urban versus rural location.

CONCLUSIONS: A large majority of patients in our urban, academic oncology clinic did not access the online communication portal. Use was associated with younger age, and lack of use was associated with residence in a lower income ZIP code. There was no association between use and gender or residence in an urban versus rural location. Future work will attempt to improve provider-patient communication through increasing access to the portal.