Evidence mapPaperPMID 41825920Full record

ArticleBMJ health & care informatics2026

Unlocking digital health: inequalities in the adoption of a patient portal.

Richard David Barker, Refik Gökmen, Daisy Naylor, James T Teo

Abstract read
In one paragraph

Article in BMJ health & care informatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Richard David BarkerKing's College Hospital NHS Foundation Trust, London, UK.
Refik GökmenGuy's and St Thomas' NHS Foundation Trust, London, UK.
Daisy NaylorGuy's and St Thomas' NHS Foundation Trust, London, UK.
James T TeoKing's College Hospital NHS Foundation Trust, London, UK james.teo@kcl.ac.uk.ORCID http://orcid.org/0000-0002-6899-8319

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDigital health apps and patient portals are proposed as part of the drive from 'analogue to digital' care for the National Health Service (NHS) 10-Year Plan. Without mitigation strategies, digital inequalities could arise as a result, and more evidence is needed to understand how to mitigate this.

methodsAs part of an equality impact assessment, a retrospective cross-sectional analysis was conducted examining patient portal activation among patients invited to outpatient appointments at two large south-east London Hospital Trusts between 1 May and 1 November 2024.

resultsOf the 503 688 patients invited to attend outpatient clinics during the study period, 52.7% had activated the patient portal. Availability of email contact details was the strongest determinant of onboarding likelihood (OR 10.86). Multivariate logistic regression models showed that the following groups were less likely to activate the patient portal: men (OR 0.84), individuals at the extremes of age (71-80 or 11-20 years), those of mixed or undefined ethnicity (OR 0.58), those of black ethnicity (OR 0.62) and those with the highest degree of socioeconomic deprivation (Index of Multiple Deprivation group 1; OR 0.68).

conclusionThis large-scale roll-out of a digital health portal provides empirical evidence of factors that drive digital inequalities for patients of two major London NHS Trusts. The observed disparities across demographic and socioeconomic dimensions and simple reliable digital contact mechanisms highlight the risk that digital healthcare initiatives may inadvertently produce new types of inequalities.

Indexed as

Healthcare DisparitiesPatient PortalsAdolescentAdultAgedAged, 80 and overChildCross-Sectional StudiesDigital HealthFemaleHumansLondonMaleMiddle AgedRetrospective StudiesSocioeconomic Disparities in HealthElectronic Health RecordsHealth EquityPatient Involvement

Identifiers

PMID41825920
PMCPMC12993344

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.