Evidence assessing rural older cancer survivors’ patient portal use is limited. To this end, we analyzed My Chart messages among this group to reveal key insights into their patient portal use.
Methods:
We conducted a retrospective qualitative chart review of MyChart messages from cancer patients aged at least 65 years and from rural ZIP codes receiving care at an urban hospital from March 1, 2020, to May 25, 2023.
Results:
The resulting sample consisted of 860 coded messages from 411 patients. The qualitative analysis yielded 1,295 coded occurrences, from which nine themes emerged. The most frequent coded messages were identified as Ongoing Clinical Care Concerns (n = 464) and Supportive Care (n = 128). The least frequently coded theme was Requesting telehealth (n = 35).
Conclusion:
Our analysis of MyChart messages of rural older cancer survivors demonstrates high engagement with MyChart messaging and has implications for the use of tailored patient portal designs for this uniquely vulnerable patient population.
KhanS, Lewis-ThamesMW, HanY, et al.A comparative analysis of online medical record utilization and perception by cancer survivorship. Med Care2020;58(12):1075–1081; doi: 10.1097/mlr.0000000000001413
2.
DanforthKN, HahnEE, SlezakJM, et al.Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: A mixed-methods study. Am J Kidney Dis2019;74(5):589–600; doi: 10.1053/j.ajkd.2019.05.003
3.
KempE, TriggJ, BeattyL, et al.Health literacy, digital health literacy and the implementation of digital health technologies in cancer care: The need for a strategic approach. Health Promot J Austr2021;32(Suppl 1):104–114; doi: 10.1002/hpja.387
4.
YoonE, HurS, OpsasnickL, et al.Disparities in patient portal use among adults with chronic conditions. JAMA Netw Open2024;7(2):e240680; doi: 10.1001/jamanetworkopen.2024.0680
5.
YoonH, JangY, VaughanPW, et al.Older adults’ internet use for health information: Digital divide by race/ethnicity and socioeconomic status. J Appl Gerontol2020;39(1):105–110; doi: 10.1177/0733464818770772
6.
LarsonJL, RosenAB, WilsonFA. The effect of telehealth interventions on quality of life of cancer survivors: A systematic review and meta-analysis. Health Informatics J2020;26(2):1060–1078; doi: 10.1177/1460458219863604
7.
ZahndW, SilvermanA, SelfS, et al.The impact of the COVID-19 pandemic on rural health clinics’ operations and cancer prevention and control efforts. J Rural Health2023;39(4):765–771; doi: 10.1111/jrh.12753
8.
LamaY, DavidoffAJ, VanderpoolRC, et al.Telehealth availability and use of related technologies among medicare-enrolled cancer survivors: Cross-sectional findings from the onset of the COVID-19 pandemic. J Med Internet Res2022;24(1):e34616; doi: 10.2196/34616
9.
Price-HaywoodEG, LuoQ. Primary care practice reengineering and associations with patient portal use, service utilization, and disease control among patients with hypertension and/or diabetes. Ochsner J2017;17(1):103–111.
10.
MaloneC, BuistDSM, TiroJ, et al.Out of reach? Correlates of cervical cancer underscreening in women with varying levels of healthcare interactions in a United States integrated delivery system. Prev Med2021;145:106410; doi: 10.1016/j.ypmed.2020.106410
11.
ConroyM, PowellM, SuelzerE, et al.Electronic medical record–based electronic messaging among patients with breast cancer: A systematic review. Appl Clin Inform2023;14(1):134–143.
12.
YedullaNR, HesterJD, PatelMM, et al.Pre-visit digital messaging improves patient-reported outcome measure participation prior to the orthopaedic ambulatory visit: Results from a double-blinded, prospective, randomized controlled trial. J Bone Joint Surg Am2023;105(1):20–26.
13.
Epic Systems Corporation. MyChart. MyChart is Epic. 2026. Available from: https://www.mychart.org/ [Last accessed: January26, 2026].
14.
JohnsonC, RichwineC, PatelV. Individuals’ access and use of patient portals and smartphone health apps, 2020. In: ASTP Health IT Data Brief. Office of the Assistant Secretary for Technology Policy: Washington, DC; 2012; pp. 1–14.
15.
Ramirez-ZohfeldV, SeltzerA, XiongL, et al.Use of electronic health records by older adults, 85 years and older, and their caregivers. J Am Geriatr Soc2020;68(5):1078–1082; doi: 10.1111/jgs.16393
BaraltM. Coding qualitative data. In: Research methods in second language acquisition: A practical guide. Wiley; 2011; pp. 222–244.
18.
BraunV, ClarkeV. Using thematic analysis in psychology. Qual Res Psychol2006;3(2):77–101.
19.
MorganDL. Focus groups as qualitative research. Sage Publications; 1996.
20.
Lewis-ThamesMW, FankP, GatesM, et al.Consequences of structural urbanism: Urban–rural differences in cancer patients’ use and perceived importance of supportive care services from a 2017–2018 Midwestern survey. Int J Environ Res Public Health2022;19(6):3405.
21.
LiuPL. Online patient-provider communication and healthy ageing: The roles of health literacy and health self-efficacy. Health Promot Int2024;39(5):daae132; doi: 10.1093/heapro/daae132
22.
DodgsonJE. Reflexivity in Qualitative Research. J Hum Lact2019;35(2):220–222; doi: 10.1177/0890334419830990
23.
BurgdorfJG, FabiusCD, WolffJL. Use of provider‐sponsored patient portals among older adults and their family caregivers. J Am Geriatr Soc2023;71(4):1177–1187.
