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The advent of the online electronic health record patient portal has provided an efficient and practical means for patients to become more involved in their health care. In this report, we analyze how demographic variables such as age, gender, race, and geographic location affect patient portal activation and usage at the University of Iowa Hospitals and Clinics, the sole academic medical center in the state of Iowa, a predominantly rural state. Our primary end points were activation of thedoi:10.1177/2374289518797573 pmid:30302394 pmcid:PMC6172938 fatcat:vltbjiepz5dyno3pu3dd7tstbi