电子健康记录 (EHR) 链接的门户可以提高癌症患者的医疗保健质量。门户访问和使用的障碍削弱了利用门户减少癌症护理差异的干预措施。本研究在改善癌症治疗期间和治疗后症状管理 (IMPACT) 联盟内实施三种基于门户的干预措施之前，检查了门户访问和门户使用的持续性以及与患者和结构因素的关联。门户使用数据是从干预措施实施前 12 个月的 EHR 中提取。还提取了社会人口因素、访问门户的模式（网络与移动）以及实施干预之前的临床接触次数。农村是使用农村城市通勤区代码得出的。宽带接入情况是根据 2015-2019 年美国社区调查进行估算的。多重逻辑回归模型测试了这些因素与门户访问（曾经访问过/从未访问过）和门户使用持续性（在 35 周的研究期间访问门户≤20 周 vs. ≥21 周）之间的关联。 在 28,942 名符合条件的患者中， 10,061 (35%) 从未访问过该门户。男性、少数族裔、农村居住、不工作和宽带接入有限与门户接入几率较低显着相关。年龄越小和临床接触次数越多，门静脉通路的几率越高。在拥有门户访问权限的用户中，25% 是长期用户。使用多种门户访问方式、中年以及有更多的临床经历与持久门户使用显着相关。患者和结构因素影响门户访问和使用，并可能加剧基于 EHR 的癌症症状监测和管理的差异。 © 作者 2023。由牛津大学出版社出版。

Electronic health record (EHR)-linked portals may improve healthcare quality for cancer patients. Barriers to portal access and use undermine interventions leveraging portals to reduce cancer care disparities. This study examined portal access and persistence of portal use and associations with patient- and structural-factors prior to the implementation of three portal-based interventions within the Improving the Management of symPtoms during And following Cancer Treatment (IMPACT) Consortium.Portal use data were extracted from EHRs for the 12 months preceding intervention implementation. Sociodemographic factors, mode of accessing portals (web vs. mobile), and number of clinical encounters prior to intervention implementation were also extracted. Rurality was derived using Rural Urban Commuting Area codes. Broadband access was estimated using the 2015-2019 American Community Survey. Multiple logistic regression models tested associations of these factors with portal access (ever access/never accessed) and persistence of portal use (accessed the portal ≤20 weeks vs. ≥21 weeks in the 35 week study period).Of the 28,942 eligible patients, 10,061 (35%) never accessed the portal. Male, racial/ethnic minority, rural dwelling, not working, and limited broadband access were significantly associated with lower odds of portal access. Younger age and more clinical encounters were associated with higher odds of portal access. Of those with portal access, 25% were persistent users. Using multiple modalities for portal access, being middle-aged, and having more clinical encounters were significantly associated with persistent portal use.Patient- and structural-factors affect portal access and use and may exacerbate disparities in EHR-based cancer symptom surveillance and management.© The Author(s) 2023. Published by Oxford University Press.