Article Figures & Data
Tables
Characteristics With Account n (%) Without Account n (%) Chi-square Statistics Total population 74,147 (72.5) 28,195 (27.5) Practice-Level Residency Clinic 17,256 (23.3) 7,970 (28.3) 274.4** Clinic Location 505.0** Urban 44,856 (60.5) 15,225 (54.0) Suburban 13,766 (18.6) 5,290 (18.8) Rural 15,525 (20.9) 7,680 (27.2) PCP-Level Faculty 68,980 (93.0) 24,959 (88.5) 551.0** Years of Practice < 5 5,482 (7.4) 3,313 (11.8) 1045.7** 5-14 26,152 (35.3) 7,757 (27.5) 15-24 22,856 (30.8) 8,173 (29.0) 25+ 19,657 (26.5) 8,952 (31.8) Patient-Level Female 43,739 (59.0) 12,823 (45.5) 1508.1** Age Group 1528.0** 18-39 25,377 (34.2) 8,262 (29.3) 40-64 19,758 (26.6) 8,082 (28.7) 65+ 5,743 (7.7) 4,325 (15.3) Race 1400.9** White 68,209 (92.0) 23,981 (85.1) Black 2,128 (2.9) 2,085 (7.4) Asian 1,899 (2.6) 836 (3.0) Hispanic 2,119 (2.9) 2,275 (8.1) 1358.4** Other 1,911 (2.6) 1,293 (4.6) Payer Category 5285.8** Commercial 62,372 (84.1) 17,964 (63.7) Medicaid 3,564 (4.8) 3,601 (12.8) Medicare 7,501 (10.1) 5,648 (20.0) Uninsured 710 (1.0) 982 (3.5) Comorbidity 58,653 (79.1) 21,964 (77.9) 17.7** Prescriptions 444.3** 0-10 22,246 (30.0) 10,356 (36.7) 11-20 14,644 (19.7) 5,038 (17.9) 21-30 9,744 (13.1) 3,096 (11.0) 31+ 27,513 (37.1) 9,705 (34.4) Lab Tests 1788.2** 0-10 19,843 (26.8) 11,326 (40.2) 11-20 16,571 (22.3) 5,681 (20.1) 21-30 11,586 (15.6) 3,430 (12.2) 31+ 26,147 (35.3) 7,758 (27.5) *p < 0.05; **p < 0.01.
Feature Domaina Feature Messaging Health Info Management Billing/Insurance Resource/Education Messaging - view 0.789 0.373 0.096 0.021 Messaging - write 0.851 0.302 0.059 0.007 Messaging - view medical 0.833 0.139 0.073 0.142 Messaging - write medical 0.879 0.224 0.088 -0.034 Appointment access 0.197 0.740 0.164 0.253 Appointment scheduling 0.188 0.574 0.146 0.092 Record access 0.269 0.688 0.075 0.045 Record management 0.105 0.510 0.078 −0.366 Visit Summary 0.188 0.783 0.103 0.118 Insurance and payment - View 0.102 0.349 0.675 0.035 Insurance and payment - Write 0.083 0.001 0.893 −0.007 Documentation 0.196 0.472 -0.005 0.501 Resource 0.104 0.142 0.036 0.889 Sums of squares (eigenvalue) 4.88 1.42 1.06 1.01 Percent of trace 37.5 10.9 8.2 7.8 ↵a Numbers are rotated factor loadings which are correlations between feature types and feature domains.
Factor loadings are marked bold for features assigned to a corresponding domain.
Characteristics Messaging, OR (95% CI) Health Info Management,OR (95% CI) Billing/Insurance, OR (95% CI) Resource/Education, OR (95% CI) Panel Months 1.007** (1.006–1.008) 1.010** (1.154–1.224) 1.003** (1.202–1.336) 1.004** (1.173–1.267) Residency Clinic 1.127** (1.089–1.167) 1.015 (0.989–1.042) 0.925** (0.883–0.968) 1.036* (1.002–1.072) Clinic Location (ref: rural) Urban 1.599** (1.534–1.666) 1.232** (1.194–1.271) 1.363** (1.288–1.442) 1.252** (1.203–1.304) Suburban 1.293** (1.243–1.345) 1.188** (1.154–1.224) 1.267** (1.202–1.336) 1.219** (1.173–1.267) Faculty 1.121 (0.955–1.315) 0.966 (0.861–1.083) 1.184 (0.980–1.429) 1.204* (1.043–1.39) Years of Practice (ref: 25+) < 5 1.058 (0.906–1.235) 1.019 (0.912–1.138) 1.211* (1.010–1.452) 1.217** (1.060–1.398) 5–14 1.263** (1.221–1.306) 1.152** (1.124–1.181) 1.182** (1.130–1.237) 1.088** (1.053–1.123) 15–24 1.121** (1.084–1.159) 1.066** (1.040–1.093) 1.071** (1.024–1.12) 1.026 (0.993–1.060) Female 1.145** (1.115–1.175) 1.105** (1.084–1.127) 1.095** (1.057–1.135) 1.326** (1.292–1.360) Age in years (ref: 65+) 18–39 1.045* (1.009–1.082) 0.985 (0.959–1.011) 0.983 (0.938–1.031) 0.933** (0.902–0.965) 40–64 1.119** (1.085–1.155) 0.962** (0.939–0.984) 0.965 (0.924–1.006) 0.888** (0.861–0.914) Race (ref: white) Black 0.471** (0.435–0.508) 0.784** (0.740–0.830) 0.625** (0.564–0.692) 1.035 (0.959–1.116) Asian 0.765** (0.706–0.828) 1.090** (1.027–1.156) 1.123* (1.009–1.249) 0.975 (0.902–1.053) Hispanic 0.710** (0.657–0.765) 0.921** (0.870–0.974) 0.964 (0.869–1.068) 1.087* (1.009–1.17) Other 0.841** (0.776–0.910) 0.951 (0.896–1.009) 0.915 (0.821–1.019) 0.968 (0.895–1.045) Payer Category (ref: commercial) Medicare 0.921** (0.880–0.963) 1.055** (1.020–1.091) 0.475** (0.447–0.504) 0.777** (0.744–0.811) Medicaid 0.765** (0.720–0.812) 0.887** (0.847–0.927) 0.306** (0.282–0.331) 1.037 (0.978–1.100) Uninsured/Self–pay 0.867* (0.761–0.985) 0.926 (0.841–1.019) 0.798* (0.671–0.948) 1.302** (1.149–1.474) Comorbidity 1.040** (1.034–1.046) 1.055** (1.050–1.059) 1.016** (1.008–1.024) 1.037** (1.031–1.043) # Prescriptions (ref: ≤10) 11–20 1.501** (1.447–1.558) 1.105** (1.075–1.136) 1.151** (1.095–1.21) 1.200** (1.157–1.243) 21–30 1.815** (1.738–1.895) 1.138** (1.101–1.175) 1.192** (1.124–1.264) 1.245** (1.194–1.299) >30 2.722** (2.614–2.835) 1.355** (1.314–1.397) 1.345** (1.272–1.422) 1.556** (1.496–1.620) # Lab tests (ref: ≤10) 11–20 1.512** (1.457–1.569) 1.635** (1.591–1.681) 1.389** (1.321–1.461) 1.244** (1.200–1.290) 21–30 1.884** (1.805–1.967) 2.087** (2.021–2.156) 1.769** (1.668–1.876) 1.385** (1.327–1.445) >30 2.814** (2.698–2.935) 3.235** (3.134–3.339) 2.280** (2.153–2.414) 1.708** (1.639–1.781) % Internet Access 1.006** (1.002–1.010) 1.002 (0.998–1.004) 1.002 (0.996–1.007) 0.999 (0.995–1.003) % HS Degree 1.014** (1.007–1.021) 1.004 (0.998–1.009) 0.997 (0.987–1.006) 1.005 (0.998–1.011) % Some College Degree 1.016** (1.010–1.022) 1.006** (1.002–1.010) 1.006 (0.998–1.014) 1.005 (0.999–1.011) % Bachelor Degree 1.019** (1.013–1.024) 1.008** (1.004–1.012) 1.004 (0.996–1.012) 1.004 (0.998–1.010) % Below Poverty 1.001 (0.997–1.003) 1.003** (1.001–1.005) 1.004* (1.002–1.007) 1.002 (0.999–1.004) Scaled Deviance 1.40 1.29 1.52 1.42 Scaled Pearson Chi–square 0.82 0.69 0.67 0.77 *p < 0.05; **p < 0.01.
Abbreviations: OR, odds ratio; 95% CI, 95% confidence interval.
Feature Feature Type Health information summary Laboratory result 5,13,14 Record access Diagnostic test result 13 Record access Health summary Record access Current health issue 13,14 Record access Health summary 14,15 Record access Medical history 13,14 Record access Problem list 14,15 Record access Immunization history 5,14,15 Record access Medication Record access History 5,13,14 Record access Request refill 13,15 Record management Allergies 13,14 Record access Preventive care reminders 13,14 Record access Contraceptive visit reminders 5 Record access STD test reminders 5 Record access Appointment management Request or cancel 13–15 Appointment scheduling Reminders 5,13,14 Appointment access History log 13 Appointment access Messaging View 13,14 Messaging (general or medical) - View Send to caregivers 5,13,14 Messaging (general or medical) - Write Patient note and goal Notes and biometric upload Record management Goal setting Record management Questionnaire Record management Referral Request Record management Summary Visit summary Visit/admission summaries 14 Visit summary Educational materials and Web resources 13 Resource General health-related information 14 Resource Document downloading or printing 13–15 Documentation Billing and insurance Insurance benefit Insurance and payment - View Billing statement Insurance and payment - View Pay online Insurance and payment - Write Provider and clinic information Resource Account management 15 Excluded in the analysis References: 5Ramsey et al. (2018); 13Elkind et al., 2017; 14Lafata et al. (2018); 15Tsai et al. (2019).
