Patient Portals and Digital Health Equity: A Patient Perspective Survey in an Internal Medicine Safety-Net Setting

Abstract

Purpose: Patient portals are important digital health tools, however, disparities in use persist among underserved populations. This study aimed to survey perceptions related to Epic MyChart among a diverse, underserved community at a safety-net institution. Methods: In-person internally developed survey administration at internal medicine clinics in 2024 captured data on demographics, MyChart awareness, usage frequency, perceived barriers, perceived benefits, and proxy support. Results: Of 200 respondents, most identified as Black (47.5%) and Hispanic/Latino (34.5%). While 35.2% reported using the portal very often (more than 12 times per year), 22.0% indicated infrequent use (1 to 6 times per year) and 26.1% reported never using. Common barriers included preferences for in-person communication (36.6%), forgetting credentials (36.6%), difficulty logging in (17.7%), and other technical or literacy challenges (12.2%). Despite barriers, a majority of respondents expressed openness to using digital tools (71.0%) and belief that tools like MyChart and virtual communication could help them manage their health more effectively (70.5%). Conclusion: Despite barriers to use, patients at a safety-net institution demonstrate interest in digital tools. Tailored strategies addressing system design and informational challenges may improve equitable portal engagement.