Shared Access to Patient Portals and Digital Health Equity (Preprint)

Abstract

Growing reliance on the patient portal as a mainstream modality in health system interactions necessitates prioritizing digital health equity through systems-level strategies that acknowledge and support all persons. Older adults with physical, cognitive, sensory, and socio-economic vulnerabilities often rely on the involvement of family and friend care partners when navigating health system demands, but their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of systematic engagement of care partners through shared access to the patient portal that have been amplified in the context of the COVID-19 outbreak and recent implementation of federal information blocking rules that promote information transparency. We describe implementation considerations, and the promise of granular, role-based privacy controls in addressing the nuanced and dynamic nature of individual information sharing preferences and fostering person- and family-centered care delivery.