Background: Understanding patterns of MyChart (Epic Systems Corp) messaging has the potential to alter clinical practice. However, because most research evaluating its use has been conducted in limited contexts, utilization patterns in patients with multiple sclerosis (MS) remain unclear. We characterized factors associated with high rates of MyChart messaging in patients with MS.

Methods: We performed a retrospective cross-sectional analysis of adult patients in an academic outpatient clinic’s database (N = 439). Inclusion criteria were one or more clinic visits and MS diagnosis. We extracted demographic and disease-specific characteristics and MyChart messaging information.

Results: MyChart users in the database totaled 74% (n = 324). MyChart users were more often younger, had shorter duration since diagnosis, had lower Patient-Determined Disease Steps scores, and were more likely to be using high-efficacy disease-modifying therapies than nonusers. Messaging rates were positively correlated with total number of unique medications (R = 0.17, P = .003) and negatively correlated with age (R = –0.11, P = .018).

Conclusions: Although research has implicated arm-hand disability and impaired vision as barriers to patient portal use, these findings suggest the relationship between MS-specific disease burden and MyChart utilization is also a function of underlying medical complexity in capacities beyond physical disability. These data may serve as groundwork for investigation into other disease-specific settings and for quality improvement research to mitigate these high rates in at-risk patients, optimizing provider time investment, clinic productivity, and patient safety and preventing health care provider burnout.

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