Hospitalized patient portal access in the post-information blocking rule era.

Background: The 21st Century Cures Act Information Blocking Rule mandates patient access to all information in their electronic medical record (EMR) without delay, cost, or special effort. Prior research into patient portal use in hospitalized adults is limited.

Objective: To better understand the characteristics of hospitalized adults who have an existing patient portal account and identify demographic factors associated with accessing information via the patient portal while hospitalized.

Methods: This single-center, cross-sectional observational study analyzed adult hospitalizations from April 5, 2021, to March 31, 2023, at Beth Israel Deaconess Medical Center (BIDMC). The primary outcome was the proportion of hospitalized patients who had an active BIDMC EMR account ("PatientSite").

Results: Of the 43,588 patients included in our analytic cohort, 13,517 (31.0%) had an active PatientSite account during their hospitalization and of those, 7311 (54.0%) accessed their account while hospitalized. A total of 62% of patients who logged into their portal also accessed clinician notes. After multivariable adjustment, patients who were older, Black, male, non-English speaking, covered by Medicaid, or from out-of-state were less likely to have an active PatientSite account. Similar disparities were found in PatientSite login and accessing clinician notes, albeit smaller in magnitude than the observed disparities in having an active account.

Conclusions: This study highlights low patient portal utilization among hospitalized patients and disparities in access based on race/ethnicity, gender, age, and insurance status.