Differences in Care Team Response to Patient Portal Messages by Patient Race and Ethnicity

The COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new normal. Prior work has documented lower message use by patients who belong to minoritized racial and ethnic groups, but research has not examined...

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Published in:JAMA network open Vol. 7; no. 3; p. e242618
Main Authors: Tang, Mitchell, Mishuris, Rebecca G., Payvandi, Lily, Stern, Ariel D.
Format: Journal Article
Language:English
Published: United States American Medical Association 18.03.2024
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ISSN:2574-3805, 2574-3805
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Abstract The COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new normal. Prior work has documented lower message use by patients who belong to minoritized racial and ethnic groups, but research has not examined differences in care team response to messages. Both have substantial ramifications on resource allocation and care access under a new care paradigm with portal messaging as a central channel for patient-care team communication. To examine differences in how care teams respond to patient portal messages sent by patients from different racial and ethnic groups. In a cross-sectional design in a large safety-net health system, response outcomes from medical advice message threads sent from January 1, 2021, through November 24, 2021, from Asian, Black, Hispanic, and White patients were compared, controlling for patient and message thread characteristics. Asian, Black, Hispanic, and White patients with 1 or more adult primary care visits at Boston Medical Center in calendar year 2020 were included. Data analysis was conducted from June 23, 2022, through December 21, 2023. Patient race and ethnicity. Rates at which medical advice request messages were responded to by care teams and the types of health care professionals that responded. A total of 39 043 patients were included in the sample: 2006 were Asian, 21 600 were Black, 7185 were Hispanic, and 8252 were White. A total of 22 744 (58.3%) patients were women and mean (SD) age was 50.4 (16.7) years. In 2021, these patients initiated 57 704 medical advice request message threads. When patients who belong to minoritized racial and ethnic groups sent these messages, the likelihood of receiving any care team response was similar, but the types of health care professionals that responded differed. Black patients were 3.95 percentage points (pp) less likely (95% CI, -5.34 to -2.57 pp; P < .001) to receive a response from an attending physician, and 3.01 pp more likely (95% CI, 1.76-4.27 pp; P < .001) to receive a response from a registered nurse, corresponding to a 17.4% lower attending response rate. Similar, but smaller, differences were observed for Asian and Hispanic patients. The findings of this study suggest lower prioritization of patients who belong to minoritized racial and ethnic groups during triaging. Understanding and addressing these disparities will be important for improving care equity and informing health care delivery support algorithms.
AbstractList The COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new normal. Prior work has documented lower message use by patients who belong to minoritized racial and ethnic groups, but research has not examined differences in care team response to messages. Both have substantial ramifications on resource allocation and care access under a new care paradigm with portal messaging as a central channel for patient-care team communication.ImportanceThe COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new normal. Prior work has documented lower message use by patients who belong to minoritized racial and ethnic groups, but research has not examined differences in care team response to messages. Both have substantial ramifications on resource allocation and care access under a new care paradigm with portal messaging as a central channel for patient-care team communication.To examine differences in how care teams respond to patient portal messages sent by patients from different racial and ethnic groups.ObjectiveTo examine differences in how care teams respond to patient portal messages sent by patients from different racial and ethnic groups.In a cross-sectional design in a large safety-net health system, response outcomes from medical advice message threads sent from January 1, 2021, through November 24, 2021, from Asian, Black, Hispanic, and White patients were compared, controlling for patient and message thread characteristics. Asian, Black, Hispanic, and White patients with 1 or more adult primary care visits at Boston Medical Center in calendar year 2020 were included. Data analysis was conducted from June 23, 2022, through December 21, 2023.Design, Setting, and ParticipantsIn a cross-sectional design in a large safety-net health system, response outcomes from medical advice message threads sent from January 1, 2021, through November 24, 2021, from Asian, Black, Hispanic, and White patients were compared, controlling for patient and message thread characteristics. Asian, Black, Hispanic, and White patients with 1 or more adult primary care visits at Boston Medical Center in calendar year 2020 were included. Data analysis was conducted from June 23, 2022, through December 21, 2023.Patient race and ethnicity.ExposurePatient race and ethnicity.Rates at which medical advice request messages were responded to by care teams and the types of health care professionals that responded.Main Outcomes and MeasuresRates at which medical advice request messages were responded to by care teams and the types of health care professionals that responded.A total of 39 043 patients were included in the sample: 2006 were Asian, 21 600 were Black, 7185 were Hispanic, and 8252 were White. A total of 22 744 (58.3%) patients were women and mean (SD) age was 50.4 (16.7) years. In 2021, these patients initiated 57 704 medical advice request message threads. When patients who belong to minoritized racial and ethnic groups sent these messages, the likelihood of receiving any care team response was similar, but the types of health care professionals that responded differed. Black patients were 3.95 percentage points (pp) less likely (95% CI, -5.34 to -2.57 pp; P < .001) to receive a response from an attending physician, and 3.01 pp more likely (95% CI, 1.76-4.27 pp; P < .001) to receive a response from a registered nurse, corresponding to a 17.4% lower attending response rate. Similar, but smaller, differences were observed for Asian and Hispanic patients.ResultsA total of 39 043 patients were included in the sample: 2006 were Asian, 21 600 were Black, 7185 were Hispanic, and 8252 were White. A total of 22 744 (58.3%) patients were women and mean (SD) age was 50.4 (16.7) years. In 2021, these patients initiated 57 704 medical advice request message threads. When patients who belong to minoritized racial and ethnic groups sent these messages, the likelihood of receiving any care team response was similar, but the types of health care professionals that responded differed. Black patients were 3.95 percentage points (pp) less likely (95% CI, -5.34 to -2.57 pp; P < .001) to receive a response from an attending physician, and 3.01 pp more likely (95% CI, 1.76-4.27 pp; P < .001) to receive a response from a registered nurse, corresponding to a 17.4% lower attending response rate. Similar, but smaller, differences were observed for Asian and Hispanic patients.The findings of this study suggest lower prioritization of patients who belong to minoritized racial and ethnic groups during triaging. Understanding and addressing these disparities will be important for improving care equity and informing health care delivery support algorithms.Conclusions and RelevanceThe findings of this study suggest lower prioritization of patients who belong to minoritized racial and ethnic groups during triaging. Understanding and addressing these disparities will be important for improving care equity and informing health care delivery support algorithms.
ImportanceThe COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new normal. Prior work has documented lower message use by patients who belong to minoritized racial and ethnic groups, but research has not examined differences in care team response to messages. Both have substantial ramifications on resource allocation and care access under a new care paradigm with portal messaging as a central channel for patient–care team communication.ObjectiveTo examine differences in how care teams respond to patient portal messages sent by patients from different racial and ethnic groups.Design, Setting, and ParticipantsIn a cross-sectional design in a large safety-net health system, response outcomes from medical advice message threads sent from January 1, 2021, through November 24, 2021, from Asian, Black, Hispanic, and White patients were compared, controlling for patient and message thread characteristics. Asian, Black, Hispanic, and White patients with 1 or more adult primary care visits at Boston Medical Center in calendar year 2020 were included. Data analysis was conducted from June 23, 2022, through December 21, 2023.ExposurePatient race and ethnicity.Main Outcomes and MeasuresRates at which medical advice request messages were responded to by care teams and the types of health care professionals that responded.ResultsA total of 39 043 patients were included in the sample: 2006 were Asian, 21 600 were Black, 7185 were Hispanic, and 8252 were White. A total of 22 744 (58.3%) patients were women and mean (SD) age was 50.4 (16.7) years. In 2021, these patients initiated 57 704 medical advice request message threads. When patients who belong to minoritized racial and ethnic groups sent these messages, the likelihood of receiving any care team response was similar, but the types of health care professionals that responded differed. Black patients were 3.95 percentage points (pp) less likely (95% CI, −5.34 to −2.57 pp;P < .001) to receive a response from an attending physician, and 3.01 pp more likely (95% CI, 1.76-4.27 pp;P < .001) to receive a response from a registered nurse, corresponding to a 17.4% lower attending response rate. Similar, but smaller, differences were observed for Asian and Hispanic patients.Conclusions and RelevanceThe findings of this study suggest lower prioritization of patients who belong to minoritized racial and ethnic groups during triaging. Understanding and addressing these disparities will be important for improving care equity and informing health care delivery support algorithms.
The COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new normal. Prior work has documented lower message use by patients who belong to minoritized racial and ethnic groups, but research has not examined differences in care team response to messages. Both have substantial ramifications on resource allocation and care access under a new care paradigm with portal messaging as a central channel for patient-care team communication. To examine differences in how care teams respond to patient portal messages sent by patients from different racial and ethnic groups. In a cross-sectional design in a large safety-net health system, response outcomes from medical advice message threads sent from January 1, 2021, through November 24, 2021, from Asian, Black, Hispanic, and White patients were compared, controlling for patient and message thread characteristics. Asian, Black, Hispanic, and White patients with 1 or more adult primary care visits at Boston Medical Center in calendar year 2020 were included. Data analysis was conducted from June 23, 2022, through December 21, 2023. Patient race and ethnicity. Rates at which medical advice request messages were responded to by care teams and the types of health care professionals that responded. A total of 39 043 patients were included in the sample: 2006 were Asian, 21 600 were Black, 7185 were Hispanic, and 8252 were White. A total of 22 744 (58.3%) patients were women and mean (SD) age was 50.4 (16.7) years. In 2021, these patients initiated 57 704 medical advice request message threads. When patients who belong to minoritized racial and ethnic groups sent these messages, the likelihood of receiving any care team response was similar, but the types of health care professionals that responded differed. Black patients were 3.95 percentage points (pp) less likely (95% CI, -5.34 to -2.57 pp; P < .001) to receive a response from an attending physician, and 3.01 pp more likely (95% CI, 1.76-4.27 pp; P < .001) to receive a response from a registered nurse, corresponding to a 17.4% lower attending response rate. Similar, but smaller, differences were observed for Asian and Hispanic patients. The findings of this study suggest lower prioritization of patients who belong to minoritized racial and ethnic groups during triaging. Understanding and addressing these disparities will be important for improving care equity and informing health care delivery support algorithms.
This cross-sectional study assesses differences in care team response to patient portal messages by patient race and ethnicity among primary care patients in the US.
Author Tang, Mitchell
Mishuris, Rebecca G.
Stern, Ariel D.
Payvandi, Lily
AuthorAffiliation 2 Harvard Business School, Boston, Massachusetts
6 Boston University School of Medicine, Boston, Massachusetts
4 Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
1 Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts
3 Digital, Mass General Brigham, Somerville, Massachusetts
7 Harvard-MIT Center for Regulatory Science, Boston, Massachusetts
5 Department of Family Medicine, Boston Medical Center, Boston, Massachusetts
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Cites_doi 10.2196/preprints.46939
10.1001/jama.2022.24710
10.1001/jamainternmed.2023.1838
10.1007/s11606-021-06682-z
10.1377/hlthaff.2021.01423
10.1001/jama.2021.13304
10.1093/jamia/ocab268
10.1377/hlthaff.2016.1651
10.1001/jamanetworkopen.2020.29650
10.2105/AJPH.2015.302903
10.1016/S2589-7500(23)00225-X
10.1093/jamia/ocz023
10.1126/science.aax2342
10.1186/s12889-016-3621-9
10.1287/mnsc.2017.2900
10.1111/milq.v100.3
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References Flanagin (zoi240120r26) 2021; 326
zoi240120r7
zoi240120r19
zoi240120r1
zoi240120r3
zoi240120r4
zoi240120r16
zoi240120r21
zoi240120r24
zoi240120r23
zoi240120r20
Beach (zoi240120r13) 2021; 36
Holmgren (zoi240120r6) 2023; 329
Adler-Milstein (zoi240120r2) 2017; 36
Hall (zoi240120r10) 2015; 105
Ayers (zoi240120r15) 2023; 183
Nong (zoi240120r11) 2020; 3
Zack (zoi240120r18) 2024; 6
Rikard (zoi240120r14) 2016; 16
Bavafa (zoi240120r8) 2018; 64
Sun (zoi240120r12) 2022; 41
Obermeyer (zoi240120r17) 2019; 366
zoi240120r25
Grossman (zoi240120r9) 2019; 26
Tang (zoi240120r22) 2022; 100
Holmgren (zoi240120r5) 2022; 29
References_xml – ident: zoi240120r4
– ident: zoi240120r25
  doi: 10.2196/preprints.46939
– ident: zoi240120r24
– volume: 329
  start-page: 339
  issue: 4
  year: 2023
  ident: zoi240120r6
  article-title: Association between billing patient portal messages as e-visits and patient messaging volume.
  publication-title: JAMA
  doi: 10.1001/jama.2022.24710
– volume: 183
  start-page: 589
  issue: 6
  year: 2023
  ident: zoi240120r15
  article-title: Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum.
  publication-title: JAMA Intern Med
  doi: 10.1001/jamainternmed.2023.1838
– ident: zoi240120r19
– volume: 36
  start-page: 1708
  issue: 6
  year: 2021
  ident: zoi240120r13
  article-title: Testimonial injustice: linguistic bias in the medical records of Black patients and women.
  publication-title: J Gen Intern Med
  doi: 10.1007/s11606-021-06682-z
– volume: 41
  start-page: 203
  issue: 2
  year: 2022
  ident: zoi240120r12
  article-title: Negative patient descriptors: documenting racial bias in the electronic health record.
  publication-title: Health Aff (Millwood)
  doi: 10.1377/hlthaff.2021.01423
– ident: zoi240120r20
– volume: 326
  start-page: 621
  issue: 7
  year: 2021
  ident: zoi240120r26
  article-title: Updated guidance on the reporting of race and ethnicity in medical and science journals.
  publication-title: JAMA
  doi: 10.1001/jama.2021.13304
– volume: 29
  start-page: 453
  issue: 3
  year: 2022
  ident: zoi240120r5
  article-title: Assessing the impact of the COVID-19 pandemic on clinician ambulatory electronic health record use.
  publication-title: J Am Med Inform Assoc
  doi: 10.1093/jamia/ocab268
– ident: zoi240120r1
– volume: 36
  start-page: 1416
  issue: 8
  year: 2017
  ident: zoi240120r2
  article-title: HITECH Act drove large gains in hospital electronic health record adoption.
  publication-title: Health Aff (Millwood)
  doi: 10.1377/hlthaff.2016.1651
– volume: 3
  issue: 12
  year: 2020
  ident: zoi240120r11
  article-title: Patient-reported experiences of discrimination in the US health care system.
  publication-title: JAMA Netw Open
  doi: 10.1001/jamanetworkopen.2020.29650
– volume: 105
  start-page: e60
  issue: 12
  year: 2015
  ident: zoi240120r10
  article-title: Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review.
  publication-title: Am J Public Health
  doi: 10.2105/AJPH.2015.302903
– ident: zoi240120r3
– ident: zoi240120r7
– ident: zoi240120r23
– volume: 6
  start-page: e12
  issue: 1
  year: 2024
  ident: zoi240120r18
  article-title: Assessing the potential of GPT-4 to perpetuate racial and gender biases in health care: a model evaluation study.
  publication-title: Lancet Digit Health
  doi: 10.1016/S2589-7500(23)00225-X
– volume: 26
  start-page: 855
  issue: 8-9
  year: 2019
  ident: zoi240120r9
  article-title: Interventions to increase patient portal use in vulnerable populations: a systematic review.
  publication-title: J Am Med Inform Assoc
  doi: 10.1093/jamia/ocz023
– ident: zoi240120r16
– volume: 366
  start-page: 447
  issue: 6464
  year: 2019
  ident: zoi240120r17
  article-title: Dissecting racial bias in an algorithm used to manage the health of populations.
  publication-title: Science
  doi: 10.1126/science.aax2342
– volume: 16
  start-page: 975
  issue: 1
  year: 2016
  ident: zoi240120r14
  article-title: Examining health literacy disparities in the United States: a third look at the National Assessment of Adult Literacy (NAAL).
  publication-title: BMC Public Health
  doi: 10.1186/s12889-016-3621-9
– ident: zoi240120r21
– volume: 64
  start-page: 5461
  issue: 12
  year: 2018
  ident: zoi240120r8
  article-title: The impact of e-visits on visit frequencies and patient health: evidence from primary care.
  publication-title: Manage Sci
  doi: 10.1287/mnsc.2017.2900
– volume: 100
  start-page: 650
  issue: 3
  year: 2022
  ident: zoi240120r22
  article-title: How emerging telehealth models challenge policymaking.
  publication-title: Milbank Q
  doi: 10.1111/milq.v100.3
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Snippet The COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new...
ImportanceThe COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a...
This cross-sectional study assesses differences in care team response to patient portal messages by patient race and ethnicity among primary care patients in...
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StartPage e242618
SubjectTerms Adult
Aged
Asian
Black or African American
Cross-Sectional Studies
Equity, Diversity, and Inclusion
Ethnicity
Female
Hispanic or Latino
Humans
Male
Medical personnel
Middle Aged
Minority & ethnic groups
Online Only
Original Investigation
Pandemics
Patient Portals
Patients
Race
Teams
Web portals
White
Title Differences in Care Team Response to Patient Portal Messages by Patient Race and Ethnicity
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