Patients, care partners, and shared access to the patient portal: online practices at an integrated health system

Objective To describe the characteristics and online practices of patients and “care partners” who share explicit access to a patient portal account at a large integrated health system that implemented shared access functionality in 2003. Materials and Methods Survey of 323 patients and 389 care partners at Geisinger Health System with linked information regarding access and use of patient portal functionality. Results Few (0.4%) registered adult patient portal users shared access to their account. Patients varied in age (range: 18–102); more than half had a high school education or less (53.6%). Patient motivations for sharing access included: to help manage care (41.9%), for emergency reasons (29.7%), lack of technology experience (18.4%), or care partner request (10.0%). Care partners were parents (39.8%), adult children (27.9%), spouses (26.2%), and other relatives (6.1%). Patients were more likely than care partners to have inadequate health literacy (54.8% versus 8.8%, P  < .001) and less confident in their ability to manage their care (53.0% versus 88.1%; P  < .001). Care partners were more likely than patients to perform health management activities electronically (95.5% versus 48.4%; P  < .001), access the patient portal (89.2% versus 30.3%; P  < .001), and use patient portal functionality such as secure messaging (39.6% versus 13.9%; P  < .001). Care partners used their own credentials (89.1%) and patient credentials (23.3%) to access the patient portal. Discussion and Conclusion Shared access is an underused strategy that may bridge patients’ health literacy deficits and lack of technology experience and that helps but does not fully resolve concerns regarding patient and care partner identity credentials.