Utilization of patient portals: a cross-sectional study investigating associations with mobile app quality.

Publication date: Sep 05, 2023

Mobile apps facilitate patients’ access to portals and interaction with their healthcare providers. The COVID-19 pandemic accelerated this trend globally, but little evidence exists on patient portal usage in the Middle East, where internet access and digital literacy are limited. Our study aimed to explore how users utilize a patient portal through its related mobile app (MyChart by EPIC). We conducted a cross-sectional survey of MyChart users, recruited from a tertiary care center in Lebanon. We collected MyChart usage patterns, perceived outcomes, and app quality, based on the Mobile Application Rating Scale (user version, uMARS), and sociodemographic factors. We examined associations between app usage, app quality, and sociodemographic factors using Pearson’s correlations, Chi-square, ANOVA, and t-tests. 428 users completed the survey; they were primarily female (63%), aged 41. 3 +/- 15. 6 years, with a higher education level (87%) and a relatively high crowding index of 1. 4 +/- 0. 6. Most of the sample was in good and very good health (78%) and had no chronic illnesses (67%), and accessed the portal through MyChart once a month or less (76%). The most frequently used features were accessing health records (98%), scheduling appointments (67%), and messaging physicians (56%). According to uMARS completers (n = 200), the objective quality score was 3. 8 +/- 0. 5, and the subjective quality was 3. 6 +/- 0. 7. No significant association was found between overall app usage and the mobile app quality measured via uMARS. Moreover, app use frequency was negatively associated with education, socioeconomic status, and perceived health status. On the other hand, app use was positively related to having chronic conditions, the number of physician visits and subjective app quality. The patient portal usage was not associated with app quality but with some of the participants’ demographic factors. The app offers a user-friendly, good-quality interface to patient health records and physicians, appreciated chiefly by users with relatively low socioeconomic status and education. While this is encouraging, more research is needed to capture the usage patterns and perceptions of male patients and those with even lower education and socioeconomic status, to make patient portals more inclusive.

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Concepts Keywords
Apps Electronic Health Record
Healthcare Lebanon
Month mHealth
Pandemic Middle East
Socioeconomic Patient portals
Usage frequency


Type Source Name
disease IDO quality
disease MESH COVID-19 pandemic
disease VO ANOVA
disease MESH education level
disease MESH chronic illnesses
disease VO frequency
disease MESH low socioeconomic status
pathway REACTOME Reproduction
drug DRUGBANK Indoleacetic acid
drug DRUGBANK Coenzyme M
disease VO Gap
disease IDO blood
disease MESH emergency
disease VO population
disease IDO process
drug DRUGBANK L-Valine
drug DRUGBANK Esomeprazole
drug DRUGBANK Ademetionine
disease VO report
disease IDO intervention
disease MESH multiple chronic conditions
drug DRUGBANK Trestolone
disease MESH noncommunicable diseases
drug DRUGBANK Sodium hydroxide
disease VO efficiency
disease VO effectiveness
drug DRUGBANK Silver
disease MESH heart failure
disease MESH Ankylosing Spondylitis
drug DRUGBANK Dihydrostreptomycin
drug DRUGBANK Troleandomycin
disease MESH cancer

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