Examining the existing usage gap of electronic health records in the United States: A study of National Health Survey

Background: Little is known about the extent of geographic variation in online health record usage and related demographic characteristics in the United States.Methods: In order to examine geographical variation in the usage of online e-health records (EHR) patient portals in the US, and the sociodemographic factors effects on the access and use of the EHR patient's portal. This study using data from the 2019 and 2020 Health Information National Trends Survey. Specifically, predictors associated with accessing patients' EHR portal were examined. Furthermore, geographic variation of EHR portal' availability and usage gap were examined and mapped.Results: Respondents had significantly higher likelihood to access EHR portals when they are higher educated, willing to seek health information online, insured and had regular providers (adjusted OR = 2.01, 95% CI: 1.44 - 2.80; adjusted OR = 3.51, 95% CI: 2.49 - 4.94; adjusted OR = 2.38, 95% CI: 1.05 - 5.43; adjusted OR = 2.1, 95% CI: 1.51 - 2.92, respectively). Individuals living in Central-West, South regions or other non-urban areas as well as deprived urban areas are less likely to access their EHR portals (adjusted OR = 0.6, 95% CI: 0.41 - 0.89). Furthermore, we found that people living in the Midwest, Southern regions, and Mountain rural areas are more likely to have greater difficulties to access EHR than other regions. Therefore, populations residing in these underserved (deprived urban, rural or remote) areas tend to face more considerable obstacles to e-healthcare.Conclusions: Improve the disparities, accessibility, and educational initiatives on the usage of eHealth resources and encouragement from both healthcare providers and policymakers should be implemented with a particular focus on targeting non-urban areas and underserved population.