The Office of the National Coordinator for Health IT examined the National Cancer Institute’s latest annual health information trends survey to identify racial and ethnic disparities in patient portal offers, access and use.


Since 2003 the NCI’s Health Information National Trends Survey has collected nationally representative data about the American public’s knowledge of, attitudes toward and use of health-related information in an effort to create more effective health communication strategies across different populations.

Overall growth in patient portal engagement has been encouraging, but prior studies have identified persistent disparities in patients’ access and use of online medical records, wrote study coauthor Chelsea Richwine, an economist with ONC’s Office of Technology, in Thursday’s HealthITbuzz blog post summarizing the findings.

Published in the Journal of the American Medical Informatics Associationthe ONC study by Richwine and her colleagues Christian Johnson and Vaishali Patel found that in 2019 and 2020, “black and Hispanic individuals were significantly less likely to report being offered and subsequently accessing their portal.”

Black and Hispanic people were not offered (5.2 percentage points less likely) and did not access patient portals (7.9 percentage points less likely) nearly as often as white people. 

After accounting for other patient engagement factors, such as age, gender, education or health status, the racial and ethnic disparities persisted, Richwine says. 

But when offered access, disparities largely diminished. According to the JAMIA abstract, “individuals offered a portal and encouraged to use it by their providers “were 21 percentage points more likely to access it.”

And, “black and Hispanic individuals who were offered and accessed a portal were 12 percentage points more likely than whites to use it to download or transmit information.” 


Information-blocking rules now in effect have expanded the variety and types of data healthcare organizations are subject to under the 21st Century Cures Act, and there are still a lot of misconceptions about requirements and how to comply.

While individuals have expressed privacy concerns, the majority of patients want to have their healthcare records readily available. Many say they want to download their health data to mobile devices.

Richwine says to reap the full benefits of policies that increase access to electronic health information, the industry must establish information-sharing best practices, alleviate patient privacy and security concerns, and address access-related barriers to use.


“Taken together, our findings point to the important role of healthcare providers in increasing access to EHI by offering portals and encouraging their use,” Richwine said in her blog.

Andrea Fox is senior editor of Healthcare IT News.
Email: [email protected]

Healthcare IT News is a HIMSS publication.


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