CCE Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


College of Engineering and Computing


Gertrude W. Abramson

Committee Member

Ling Wang

Committee Member

Kimberly W. Bartholomew


health care management, health literacy, information technology, numeracy literacy, patient literacies, patient portal


Spawned by legislative mandates, such as the American Recovery and Reinvestment Act of 2009’s Health Information Technology for Economic and Clinical Health Act, and individuals desiring to have more personal accountability for their health and healthcare, the introduction and use of electronic personal health information (ePHI) has grown substantially. Given that most ePHI is maintained within the healthcare delivery system, an information portal is required for individuals to have access to the ePHI. As a result, the legislation required the introduction and use of patient portals to grant such access.

Despite substantial financial incentives and disincentives for healthcare organizations to provide and promote the use of patient portals, actual utilization of patient portals has fallen significantly short of expectations and desires. It has been posited that limited patient portal utilization may have been related to multiple factors, with no definitive set of factors empirically established as the root cause. While patient age and gender exhibit some relation to patient portal utilization, those factors are not able to be modified, thereby limiting any potential to change utilization. Therefore, there is an interest to identify other variables that can be modified to have an impact on patient portal utilization.

The study sought to contribute to the body of knowledge concerning factors that impact the utilization of patient portals, specifically, how patient literacies, i.e., computer/Internet, health, and numeracy impact patient portal utilization. These literacies for 400 University of Maryland Medical System patients were assessed via self-administered surveys, with the results compared to their actual patient portal utilization. The goal was to identify related correlations between literacy scores and utilization, using the correlations to construct a portal use index capable of accurately predicting utilization based on these literacies. However, Kendall tau-b correlation coefficients indicated an absence of significant correlations between patient literacies and patient portal use.