Access, Interest, and Attitudes Toward Electronic Communication for Health Care Among Patients in the Medical Safety Net

Schickedanz, Adam; Huang, David; López, Andrea; Cheung, Edna; Lyles, Courtney R.; Bodenheimer, Tom; Sarkar, Urmimala

doi:10.1007/s11606-012-2329-5

Cited by 117 publications

(77 citation statements)

References 20 publications

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“…The inattention may also cause smartphone users to miss the social cues that signal the discourtesy of ignoring people who are immediately present. 4 Clinicians are perhaps particularly susceptible to repetitive checking because their messages sometimes contain important patient updates that require urgent action. A great deal of self-discipline or external authority is required to counteract this addictive behavior.…”

Section: Surrounding Neglectmentioning

confidence: 99%

Pitfalls with Smartphones in Medicine

Redelmeier

Detsky

2013

J GEN INTERN MED

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Section: Surrounding Neglectmentioning

confidence: 99%

Pitfalls with Smartphones in Medicine

Redelmeier

Detsky

2013

J GEN INTERN MED

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“…Second, there are large groups who both want and need technology training, especially since large proportions of diverse patient populations report wanting access to electronic access to healthcare information. 12 This issue of training is not a one-size-fits-all approach: some individuals still need training to be able to use computers or other devices, but others who are already online performing basic searches for healthcare information may need more focused training to be able to perform sophisticated tasks, such as using a secure password. We see the potential for tiered technology training approaches to improve the health literacy status and patient activation levels of vulnerable patients who are interested in accessing technology to help manage their health and healthcare.…”

mentioning

confidence: 99%

Health Literacy, Vulnerable Patients, and Health Information Technology Use: Where Do We Go from Here?

Lyles

Sarkar

2015

J GEN INTERN MED

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In the past few years, the rapid adoption of health information technology (HIT) in the US has been very apparent, largely driven by the more than $25 billion in incentives for "Meaningful Use" of HIT provided to date as a part of healthcare reform in the Health Information Technology for Economic and Clinical Health (HITECH) Act. As we move into Stage 2 of the Meaningful Use program with new metrics for patient engagement, healthcare leaders are now shifting their focus from implementation to understanding patient needs and preferences for health technology use. The article by Levy et al. 1 in this issue highlights an important issue in this landscape: the intersection of vulnerable populations and HIT use.At the national level, the Pew Research Center's Internet and American Life Project estimates that the gaps in technology use (that is, the "digital divide") are shrinking. In 2014, 87 % of US adults accessed the Internet including 81 % of African Americans, 83 % of Hispanics/Latinos, and 77 % of those making less than $30,000 annually.2 Thus, many view HIT as a mechanism to reach diverse populations to engage in health.Despite this, there is not much evidence about how HIT use will affect health outcomes or address existing health disparities. The underlying assumption behind incentives to encourage health systems to implement patient portals is that these portals will improve health. While the evidence is far from conclusive, studies do suggest that patient portals can improve processes of care and adherence. 3,4 Technology is also thought to benefit health through improved patient activation and selfmanagement achieved via access to online health information and peer support. 5,6 However, clear and consistent evidence related to health disparities is lacking.In this issue of JGIM, Levy et al. have honed in on an important subgroup where the digital divide persists: those aged 65 years or older, only 57 % of whom are Internet users. Within this older group, the authors were able to explore additional predictors of Internet use-namely, health literacy, which has been previously shown to predict online portal use. 7They also explored patterns of searching for health information online as opposed to simply noting the presence or absence of any Internet use. The results aren't surprising when examining the barriers of age and health literacy simultaneously: only 32 % of older adults used the Internet to get health information and only 10 % of older adults with limited health literacy did so. This was after adjustment for the major potential confounder of cognitive ability.This pattern is also likely to hold within other subgroups not specifically examined in this study, such as income and race/ethnicity. It is clear from national data that older adults with lower income or from racial/ethnic minority groups are least likely to use the Internet. 8 For example, only 25 % of low-income older adults use the Internet at all, 9 compared to more than 50 % of older adults overall. Furthermore, not only are health li...

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“…Gender and BMI may indicate a barrier to information technology use in adolescents and practitioners [50][51][52], but reported disparities in adoption of Internet-based health correspond more with lower income, educational attainment, ethnic background, and those for whom English is not their native language [53]. Gender and BMI influence on engagement was equivocal in terms of the odds reported in this study; the student sample here may be more consumer-driven, aligned to recent shifts in UK higher education with strong emphasis on student choice and experience and less on gender-based decisions [49].…”

Section: Discussionmentioning

confidence: 99%