ABSTRACT
INTRODUCTION: Use of electronic patient health portals (EMRPHP) was stressed during the first year of the COVID-19 pandemic as an important vehicle for equitable access to healthcare information. Disparate use of the EMR-PHP according to race, age, ethnicity, and insurance status has been reported. Less is known about disparities associated with EMR-PHP use in pregnancy. Further, the effect of the COVID-19 pandemic on EMR-PHP utilization according to race/ ethnicity is unclear. METHODS: Institutional review board approval was obtained through Vanderbilt University Medical Center. A retrospective cohort study of patients who delivered and received prenatal care between 2018 and October 2021 was performed. Demographic and EMR-PHP activation/use data were stratified by race, ethnicity, and language. Differences in EMR-PHP registration/use in 2019 and in 2020, during the first year of the COVID-19 pandemic, were determined according to race, ethnicity, and primary language. RESULTS: In 2019-2020, an average of 4,400 patients delivered and selfidentified as: White (54%), Black (17%), Hispanic (17%), English language (EL) (80%), and Spanish language (SL) (20%). EMR-PHP registration/use increased in 2020 for all patients. EMR-PHP registration increased more in Hispanic (44% increase 2020 vs 2019) and SL (54% increase 2020 vs 2019) patients compared to White and EL patients (P<.05). Despite significant gains in 2020, Hispanic and SL patients were less likely to register/use the EMR-PHP compared to White and EL patients at the time of delivery (P<.01). CONCLUSION: Significant disparities in EMR-PHP registration and use were identified in pregnancy. The patient, provider, and digital health access factors underlying low rates of EMR-PHP use in underserved populations require further investigation.