Patterns of Health Portal Use by Regular Portal Users Among Patients With Cancer: Results From the UWCCC Survivorship Program.

PURPOSE: We sought to evaluate the patterns of portal usage among patients with cancer who regularly log in to the portal. These data will inform approaches to facilitate portal use among patients with cancer. PATIENTS AND METHODS: We conducted a retrospective analysis of patient portal usage by patients with cancer at the University of Wisconsin Carbone Cancer Center. Our analysis focuses on patterns of portal use by regular users (≥ 2 portal logins/year, > 3 months) receiving ongoing oncology care between January 1, 2017, and December 31, 2019. Demographics, cancer characteristics, number of oncology visits per month, and portal usage data were extracted. Regular portal users were grouped and compared on the basis of their frequency of use. A linear mixed-effects model was used to determine if the frequency of oncology visits influenced the number of logins. RESULTS: We identified 2076 regular portal users. The median number of portal logins/year was 72 for the entire cohort. Age and race were associated with frequency of portal logins. There was no difference in frequency of portal login on the basis of cancer type or stage. Each additional oncology office visit in a month increased the frequency of portal logins by 3.05 ± 0.11 (SE) within the same month. Messages and test result functionalities were used by 98.7% and 98.9% of the regular users, respectively. Regular users who logged in to portal more frequently used all five studied portal functionalities. CONCLUSION: Patients with cancer who use portals regularly use it more in proximity to an oncology office visit and use multiple available portal functionalities. These findings can direct strategic planning to facilitate portal utilization among those not engaged with this tool.

Patterns and predictors of cancer-specific patient health portal usage among patients with cancer: results from the UWCCC Survivorship Program.

BACKGROUND: Portals can assist patients in managing their healthcare. Understanding how patients with cancer use portals can facilitate improvements in patient engagement in cancer care. This study sought to determine if patients with cancer used portals differently for cancer versus noncancer purposes. The effects of geographic residence (rural vs. urban residence) and cancer stage on portal usage were also investigated. METHODS: We conducted a retrospective analysis of portal usage by patients seen at an NCI-designated cancer center between 2015 and 2019. Demographics, cancer characteristics, and portal usage (number of successful logins, messages sent, and results viewed) were extracted. Messages sent and results viewed in the portal were deemed oncologist-specific and cancer specific if sent to or ordered in medical oncology departments, respectively. RESULTS: The analysis included a total of 5950 patients with cancer. Patients were less likely to send and view oncologist-specific messages compared to non-oncologist-specific messages. They were also less likely to view cancer results compared to noncancer results. Compared to urban counterparts, patients residing in rural areas had lower odds of having any logins and logged in less frequently during the year of diagnosis. Compared to patients with non-metastatic disease, individuals with metastatic disease were more likely to become frequent portal users. CONCLUSIONS: Patients may use portals differently for cancer versus noncancer purposes; urban residence and metastatic cancer were associated with more frequent usage. Further investigation can inform interventions to increase accessibility for groups at a disadvantage related to the use of this technology and to help patients better leverage portals to manage their cancer.

Electron transfer control in soluble methane monooxygenase.

The hydroxylation or epoxidation of hydrocarbons by bacterial multicomponent monooxygenases (BMMs) requires the interplay of three or four protein components. How component protein interactions control catalysis, however, is not well understood. In particular, the binding sites of the reductase components on the surface of their cognate hydroxylases and the role(s) that the regulatory proteins play during intermolecular electron transfer leading to the hydroxylase reduction have been enigmatic. Here we determine the reductase binding site on the hydroxylase of a BMM enzyme, soluble methane monooxygenase (sMMO) from Methylococcus capsulatus (Bath). We present evidence that the ferredoxin domain of the reductase binds to the canyon region of the hydroxylase, previously determined to be the regulatory protein binding site as well. The latter thus inhibits reductase binding to the hydroxylase and, consequently, intermolecular electron transfer from the reductase to the hydroxylase diiron active site. The binding competition between the regulatory protein and the reductase may serve as a control mechanism for regulating electron transfer, and other BMM enzymes are likely to adopt the same mechanism.