Poll: More Older Adults Tap Patient Portals, but Usage Varies Widely

Wealthier white older adults were more likely to report using virtual care portals.

More older adults are using telehealth compared with five years ago, but a new poll shows major disparities along incomes, race, and ethnicity.

The University of Michigan National Poll on Healthy Aging found that 78% of people aged 50 to 80 have used at least one patient portal, up from 51% in a poll taken in pre-pandemic 2018. Of those with portal access, 55% had used it in the past month, and 49% use more than one portal.

However, the poll responses skew against older adults with annual household incomes below $60,000, Blacks or Hispanics, all of whom generally have lower rates of portal use, and are less likely to say they're comfortable using a portal, than respondents who are higher-income or non-Hispanic White.

Variations also were reported among older adults who say they're in fair or poor health physically or mentally are more likely to say they're not confident about their ability to log in and navigate a portal.

Even among older adults who use portals, the poll shows many prefer phone calls for scheduling or medical questions. However, portal users in general say they prefer the portal to the phone when getting test results and requesting drug refills.

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine.

The jump in portal use between polls done in 2018 and 2023 coincides with the rise of telehealth visits during the COVID-10 pandemic, says Denise Anthony, Ph.D., the U-M School of Public Health researcher, which prompted providers to supplement video visits within their secure websites and apps.

"This change makes access to secure portals even more important for older adults who want to see their doctors and other healthcare providers virtually. It also makes the disparities we found in our poll even more troubling," says Anthony, chair the Department of Health Management and Policy.

"Improving the functionality and accessibility of portal systems, as well as providing more outreach and training to help patients understand and use portal systems, will be crucial to improving equity," Anthony says.

Many portals allow patients who have created their own accounts to also grant a loved one access to some or all of their information, so they can help manage their healthcare. The new poll shows

The polls shows that nearly half (49%) of portal have granted access to their portal accounts to a spouse, partner or relative , users have done so, up from 43% in 2018, with 48% of men doing so compared with 32% of women.

Poll director Jeffrey Kullgren, MD, MPH, MS, an associate professor of internal medicine at Michigan Medicine, says that a "growing body of evidence shows that patients who use portals to access their information are more likely to take an active role in their care and stick to the treatment plan their physicians and other providers recommend, which we know is likely to lead to better outcomes." 

Kullgren says 27% of the poll respondents who've used a portal in the last year say they want more training. The percentage was higher among older adults who haven't used a portal recently, and those who are Black, Hispanic or have incomes below $60,000.

Kullgren says providers should make an effort to engage and support patients who have not accessed a portal, and to offer training to bolster confidence and encourage sharing access with trusted loved ones.

"This is especially important for patients who have complex health needs or multiple conditions," he says. 

Indira Venkat, senior vice president of research at AARP says the increased use of virtual care by older adults is encouraging, but that more needs to be done.

"Research shows that while more older Americans are embracing technology, nearly 22 million older adults still do not have wireline broadband access at home, limiting their access to essential digital healthcare services like patient portals," Venkat says. "Closing the digital divide among older adults is critical to improving their wellbeing, especially for vulnerable communities and individuals."

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in January 2023 among 2,563 adults aged 50 to 80.