In the digital age, healthcare delivery has undergone a transformative shift, with patient portals becoming an integral tool for managing care remotely. These portals, accessible via smartphones and computers, enable patients to engage in telehealth appointments, view prescription and laboratory data, communicate securely with healthcare providers, and more. However, a groundbreaking study from the University of Michigan reveals a critical shortfall in this technological evolution—patient portal accessibility is not equitably extended to individuals with limited English proficiency (LEP), a vulnerable segment numbering over 25 million in the United States.
The study rigorously analyzed the language offerings on patient portal login pages across 511 hospitals situated in 51 counties within 17 states. These regions were intentionally selected based on census data identifying substantial LEP populations, exceeding 300,000 residents each. Investigators focused on the patient portal’s “front door,” the login interface, as a gateway to digital health services. Astonishingly, they discovered that nearly 29% of these hospital portals are exclusively available in English, impeding access for non-English speakers from the outset.
Further compounding the issue, approximately 60% of hospitals offer portal access in only two languages: English and Spanish. This bilingual limitation effectively sidelines patients who communicate in other predominant languages within their communities. A mere 11% of hospitals provide multilingual options that include English, Spanish, and an additional language. Intriguingly, less than 5% of hospitals tailored their portal login prompts to the most prevalent non-English, non-Spanish language spoken locally, underscoring a significant mismatch between patient demographics and digital resource availability.
The implications of these findings extend beyond mere convenience. Patient portals serve as critical conduits for healthcare interaction in the modern era, especially post-COVID-19, when telehealth has become standard practice. Dr. Debbie W. Chen, a clinical assistant professor and lead author, articulates that failure to offer accessible portals may deprive LEP patients of essential services such as virtual consultations and secure messaging with their healthcare teams. This exclusion can potentially exacerbate health disparities, as these patients may miss timely interventions and guidance that are routinely available to English-speaking counterparts.
Regulatory frameworks like Section 1557 of the Affordable Care Act mandate that federally funded entities, such as hospitals receiving Medicare reimbursement, provide healthcare services in a linguistically accessible manner. In practice, this has translated into the availability of in-person and digital interpreter services within clinical settings. However, the study indicates that these policies have not fully permeated the design and implementation of patient portals, a digital extension of traditional care.
Teaching hospitals, institutions where new physicians undergo training, showed greater propensity to provide translated portal interfaces. This may reflect heightened awareness or resources available within academic medical centers to address linguistic diversity. Additionally, the study highlighted that hospitals utilizing major patient portal vendors like Epic MyChart and Cerner exhibited better multilingual support. This finding suggests that technical vendor capabilities and partnerships could be leveraged to enhance linguistic inclusivity across the healthcare IT landscape.
Dr. Chen emphasizes that the challenge extends beyond merely translating login interfaces. Usability testing in multiple languages is essential to ensure that patient portals are genuinely navigable and helpful for LEP users. User experience factors such as readability, cultural relevance, and interface design profoundly impact engagement and health outcomes for non-English speakers.
Furthermore, language barriers in healthcare are multifaceted and extend into other areas, including appointment scheduling and cancer care navigation, areas where Dr. Chen’s prior research has found similar accessibility concerns. These systemic barriers cumulatively hinder LEP patients’ access to high-quality, timely care and highlight the pressing need for comprehensive linguistic accommodation across all healthcare touchpoints.
The necessity to address linguistic gaps in patient portal design is accentuated by demographic trends showing a rising LEP population in the U.S. As digital health platforms continue to expand their roles in care coordination, inclusivity must become a foundational principle for technology deployment in healthcare settings. The University of Michigan study calls hospitals and health systems to action, advocating for proactive collaborations with portal vendors and adherence to federal mandates to improve health equity.
In conclusion, ensuring that patient portals are accessible in multiple languages is not only a regulatory requirement but also a moral imperative to bridge health disparities in an increasingly diverse society. The study’s findings underscore the potential for digital health technology to either exacerbate or mitigate inequities, dependent on thoughtful design and policy implementation. As the healthcare industry embraces digital transformation, embedding language inclusivity into patient portal infrastructure stands as a vital step toward equitable healthcare access.
Subject of Research: Not applicable
Article Title: Language Barriers and Access to Hospital Patient Portals in the US
News Publication Date: 16-Oct-2025
References:
Chen DW, Watanabe M, Xie S, Huston-Paterson HH, Banerjee M, Haymart MR. Language Barriers and Access to Hospital Patient Portals in the US. JAMA Network Open. 2025; doi:10.1001/jamanetworkopen.2025.37864
Keywords:
Language discrimination, Health equity, Hospitals, Health care delivery, Health care policy, Internet, User interfaces
