Professor University of California San Diego University of California San Diego San Diego, California, United States
Background: Functional health literacy (FHL) is essential for disease self-management and healthcare engagement. With the advent of patient electronic health record (EHR) portals, patients now have unprecedented access to health information. Adolescents and young adults (AYA) with chronic disease must gain adequate FHL to play an active role in their own care as they prepare for the transition from pediatric to adult centered care.
Objective: We evaluated the relationship between FHL and EHR patient portal use among AYA evaluated at a chronic disease clinic.
Design/Methods: For the past 2 years, at our Inflammatory Bowel Disease (IBD) center, AYA (>12 years old) with chronic disease (IBD) undergo a FHL assessment. The 16-question assessment evaluates various domains of FHL including disease knowledge, disease self-management skills, and healthcare access skills. Competency is defined by assessment score and is based on age (12-14y: 65% correct; 15-17y: 75% correct; and 18+: 85% correct).
Among AYA who had undergone a FHL assessment, we evaluated EHR patient portal activation. Among AYA who had an active EHR patient portal for >6 months and had logged into the portal at least once, we also assessed annual EHR patient portal usage (Figure 1). Group comparisons based on FHL competency were evaluated by chi-square analysis for categorical outcomes and Wilcoxon rank sum test for non-normally distributed outcomes.
Results: 88 out of 195 AYA demonstrated competency in FHL. 85% AYA with inadequate FHL v. 94% AYA with adequate FHL activated their EHR patient portal (p=0.04).
Among the 85 AYA who had an active EHR patient portal for >6 months and had accessed information at least once via the portal, AYA with adequate FHL demonstrated greater EHR patient portal usage (measured by annual logins and viewing of test results and notes) as compared to counterparts who did not demonstrate FHL competency (Figure 1). While messages were more often checked by those with FHL competency v. counterparts, this difference did not reach statistical significance (p=0.06) Conclusion(s): Among AYA with chronic disease, FHL competency is significantly associated with greater EHR patient portal activation and usage. Our findings confirm the need for FHL competency to promote continued patient engagement with their own health information. Future studies will need to evaluate whether competency in FHL and engaged patterns of EHR patient portal usage are associated with improved health outcomes.
Authors/Institutions: Jeannie Huang, University of California San Diego, La Jolla, California, United States; Matthew Definis, Rady Children's Hospital San Diego, San Diego, California, United States; Jacob Parker, Rady Children's Hospital San Diego, San Diego, California, United States