Growth Dynamics of Patient-Provider Internet Communication: Trend Analysis Using the Health Information National Trends Survey (2003 to 2013)

Abstract

BackgroundCommunication is key in chronic disease management, and the internet has altered the manner in which patients and providers can exchange information. Adoption of secure messaging differs among patients due to the digital divide that keeps some populations from having effective access to online resources.ObjectiveThis study aimed to examine the current state of online patient-provider communication, exploring trends over time in the use of online patient-provider communication tools.MethodsA 3-part analytic process was used to study the following: (1) reanalysis, (2) close replication across years, and (3) trend analysis extension. During the reanalysis stage, the publicly available Health Information National Trends Survey (HINTS) 1 and 2 data were used with the goal of identifying the precise analytic methodology used in a prior study, published in 2007. The original analysis was extended to add 3 additional data years (ie, 2008, 2011, and 2013) using the original analytical approach with the purpose of identifying trends over time. Multivariate logistic regression was used to analyze pooled data across all years, with year as an added predictor, in addition to a model for each individual data year.ResultsThe odds of internet users to communicate online with health care providers was significantly and increasingly higher year-over-year, starting in 2003 (2005: odds ratio [OR] 1.31, 95% CI 1.03-1.68; 2008: OR 2.14, 95% CI 1.76-2.59; 2011: OR 2.92, 95% CI 2.33-3.66; and 2013: OR 5.77; 95% CI 4.62-7.20). Statistically significant socio-economic factors found to be associated with internet users communicating online with providers included age, having health insurance, having a history of cancer, and living in an urban area of residence.ConclusionsThe proportion of internet users communicating online with their health care providers has significantly increased since 2003. Although these trends are encouraging, access challenges still exist for some groups, potentially giving rise to a new set of health disparities related to communication.

Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003–2018

“…The increasing trend for emailing doctors found in our study of cancer survivors was also seen in the general US population. A recent study using HINTS data from 2003 to 2013 found that OPPC among US adults rose from 7% in 2003 to 30% in 2013 as well as a significant increase in the proportion of internet users communicating with their providers using email [29]. However, our findings also suggest a flatlining of the proportion of survivors emailing their doctors since 2013.…”

Relations Between the Use of Electronic Health and the Use of General Practitioner and Somatic Specialist Visits in Patients With Type 1 Diabetes: Cross-Sectional Study

“…This study confirms that younger people use the internet for health purposes more than older people, particularly apps and search engines. Previous research is consistent regarding this age divide for general populations, elderly populations, and populations with chronic disease [ 10 , 11 , 15 , 17 , 33 , 37 - 41 ]. Findings by Tarver et al may indicate that age differences among internet users decreased in the period from 2003 to 2013, although this finding was not statistically significant [ 41 ].…”

“…Previous research is consistent regarding this age divide for general populations, elderly populations, and populations with chronic disease [ 10 , 11 , 15 , 17 , 33 , 37 - 41 ]. Findings by Tarver et al may indicate that age differences among internet users decreased in the period from 2003 to 2013, although this finding was not statistically significant [ 41 ]. This possible trend may amplify when cohorts exposed to digital technology from childhood get older, and the present inverse association between age and eHealth use might not be sustained to the same extent in the future.…”

Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study

“…Studies have consistently shown that patient portal usage has increased over time but remains low overall [ 10 , 20 , 21 ]. A recent nationally representative study (weighted n=254,183 individuals) found a significant increase in the adoption of patient portals in the United States, from 12.5% in 2011 to 25.0% in 2017 ( P <.001) [ 10 ].…”