N. Magalit1, S. Sinha1, K. Natsuhara2, J. H. Chang3, G. Cain1, R. Benson1, and J. C. Hong1; 1Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 2Division of Hematology & Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, 3Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Seoul, Korea, Republic of (South)
Purpose/Objective(s):Navigating cancer care requires longitudinal, multidisciplinary coordination by patients. Patient portals allow patients to interact with their health information and can assist with managing cancer care. Disparities across race in patient portal use among patients with cancer have been linked to lower quality care. Little is known about patient portal use over the cancer care continuum or the extent to which specific portal action use varies by race. To identify longitudinal portal use patterns among patients with cancer and disparities based on race, we analyzed patient portal data of a radiation oncology department. Materials/
Methods: This study included a retrospective cohort of 6,064 patients aged = 18 years with an encounter in radiation oncology at a single institution from 01/01/2017 to 11/30/2023 and any patient portal use. We then performed a descriptive analysis and visualization of longitudinal patient portal use by race. Results: Between January 2017 and November 2023, there were 25,777 patients with a completed visit at the radiation oncology department at a single institution. Of these patients, 20,008 (78%) had patient portal accounts and 6,064 (24%) had used the portal. White patients accounted for 61% of portal users, Asian patients accounted for 15%, and Black patients accounted for 5%. From June 2012 to November 2023, portal action counts grew 280%. White (67%) and Asian (21%) patients accounted for proportionately more portal actions compared to Black patients (3%). Asian patients performed 42% more portal actions per monthly user versus White and Black patients. Visits (manage appointments), Test Result Details (view labs/imaging), Inpatient Admissions (view admission and after visit summary), Messaging (send/receive messages), and Test Results List (view list of test results) were the most popular patient portal actions, representing almost 50% of all actions. Messaging rapidly decreased from >10% to <1% of total portal actions from September 2021 to December 2021. When looking at the distribution of top patient portal actions by race, White patients (10%) spent a larger proportion of portal actions on Test Result Details compared to Asian (5%) and Black patients (8%). Test Result Details peaked to >50% and declined to <5% of total portal actions in Black patients from September 2020 to December 2020. Asian (9%) and Black patients (8%) spent a larger proportion of portal actions on Inpatient Admissions compared to White patients (7%). White and Black patients (6%) spent a larger proportion of portal actions on Messaging compared to Asian patients (5%). Conclusion: These findings illustrate differences in portal use among radiation oncology patients across race, which may provide additional insight into the range of patient needs and preferences that arise during the cancer care journey. Abrupt changes in action percentages could be due to external factors like institutional policy changes (e.g., billing for patient portal messages) or the COVID-19 pandemic.
