Assessing the Effects of eHealth Literacy and the Area Deprivation Index on Barriers to Electronic Patient Portal Use for Orthopedic Surgery: Cross-Sectional Observational Study

Low eHealth literacy was the most significant determinant of overall barriers to EPP use for orthopedic surgery, followed by older age. Neighborhood-level disadvantage as measured through the ADI had no mediating effect on patient-reported barriers to EPP use when adjusting for eHealth literacy level. While patients with physical access barriers had higher ADIs, overall, few patients reported physical access barriers compared to barriers related to technology discomfort or preference. Patient preference for EPP versus non-EPP communications should be documented. Point-of-care screening using the eHealth Literacy Scale may also identify patients who require follow-up outside of the EPP during critical perioperative periods.