Black Americans have long struggled to obtain equitable and efficient access to health care, and a new study published in JAMA Network Open indicates that the issue extends to patient portals.
According to CBS News, researchers analyzed patient portal message responses from over 39,000 patients at Boston Medical Center in 2021, including the types of health care experts who responded and how quickly they replied to medical advice requests.
“When patients who belong to minoritized racial and ethnic groups sent these messages, the likelihood of receiving any care team response was similar,” the authors noted in their findings, “but the types of health care professionals that responded differed.”
Black patients noted a response rate from attending physicians almost 4 percentage points lower and a response rate from registered nurses about 3 percentage points higher. The authors observed comparable but more minor differences for Asian and Hispanic patients.
The study suggests several explanations for the phenomenon, including message content, implicit bias, and physician time constraints.
Researchers expressed concern that messages from minority patients are “less likely to be prioritized for physician response,” as triaging nurses usually view patients’ emails before anyone else.
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According to the authors, patient “health literacy” — which the Centers for Disease Control and Prevention defines as the extent to which people can “find, understand, and use information and services to inform health-related decisions and actions for themselves and others” — may also play a role.
Technology developments in health care, including artificial intelligence (AI), have the potential to enhance care. Still, some experts are concerned that new systems may amplify the racial bias that has long persisted in the medical field.
“Our system in America is not built to serve everyone equally,” Dr. Leigh-Ann Webb, an assistant professor of emergency medicine at the University of Virginia, previously told CBS, “and the health care system is not immune to that.”
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