Not Speaking the Same Language—Lower Portal Use for Limited English Proficient Patients in the Los Angeles Safety Net

Casillas, Alejandra; Abhat, Anshu; Vassar, Stefanie D.; Huang, David; Simmons, Sara; Lyles, Courtney R.; Portz, Jennifer Dickman; Moreno, Gerardo; Brown, Arleen F.

doi:10.1353/hpu.2021.0182

Cited by 11 publications

(12 citation statements)

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“…Many are familiar with the 'first order digital divide,' (i.e., lack of infrastructure) but, lesser known is the 'second-order digital divide,' which includes Internet skill deficits, lacking social capital, and poor digital consumption choices. Both divides disproportionally affect already marginalized groups and communities, particularly those with lower socioeconomic status (Gonzales 2016), users of color (Gonzales et al, 2020;Wodajo and Kimmel 2013), and developing nations (Ayodele, 2020), constraining opportunities, agency, and choices across multiple social institutions (see van Duersen and van Dijk, 2019;Camerini et al, 2018;Casillas et al, 2021;Nguyen et al, 2020). For example, children from low socioeconomic status families often frequent the Internet for entertainment and socializing purposes, which correlates with poor grades and increased social inequalities (Camerini et al, 2018).…”

Section: Emerging Social Practicesmentioning

confidence: 99%

“…For example, children from low socioeconomic status families often frequent the Internet for entertainment and socializing purposes, which correlates with poor grades and increased social inequalities (Camerini et al, 2018). Language barriers limit non-English speakers use of patient portals, limiting their access to quality healthcare and information (Casillas et al, 2021).…”

Section: Emerging Social Practicesmentioning

confidence: 99%

“…Meanwhile, the Internet marginalizes non-English speakers as much of the Internet operates in English, barring them access to important information or benefits, such as healthcare portals (Casillas 2021). Also, gender non-conforming, gay, displaced migrants of color living on the margins in Europe are less able to plug into social networks in their receiving country to acquire 21 resources and learn the cultural expectations of their host country than wealthy, white, and Western, young, gay men who migrated voluntarily, which creates disadvantages in other institutional spheres such as employment, healthcare, and housing (Patterson and Leurs, 2019).…”

Section: Powermentioning

confidence: 99%

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The Internet as a social institution: Rethinking concepts for family scholarship

Longo

2023

Family Relations

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I argue that scholars study the Internet as a social institution. This study employs a critical literature review of multi-disciplinary scholarship on the Internet, the family, and adjacent institutions comparing it to Patricia Yancy Martin's (2005) fourteen criteria of social institution to demonstrate how the Internet represents a new social institution, worthy of inquiry through its fourteen defining characteristics of endurance (persistence over time), social practices, conflicts, power struggles, identity formation, and change, among other criteria (Martin 2004; 1256). I, then, I discuss the potential starting points of digital data research methods for newcomers to the field, such as data acquisition, coding potential, and approaches to analysis. Conceptualizing the Internet as a social institution will ultimately improve the evaluation of peer-reviewed digital research, expand social theory more broadly, elevate our awareness of the Internet's sociality, and subject the interconnections of the social institution of the Internet and other social institutions to more critical investigations.

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Section: Emerging Social Practicesmentioning

confidence: 99%

Section: Emerging Social Practicesmentioning

confidence: 99%

Section: Powermentioning

confidence: 99%

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The Internet as a social institution: Rethinking concepts for family scholarship

Longo

2023

Family Relations

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“…53 Sexually transmitted infection telehealth services that fail to adapt to the linguistic differences and literacy challenges of patients, for example, or recognize the possible impact of patients' socioeconomic conditions on Internet access risk exacerbating health inequities. [54][55][56] Among persons experiencing homelessness, for example, telehealth service delivery, if it includes an audio-only option, can increase access to providers, but these services do not substitute for clinic-based social services and support. 57 Furthermore, even for those persons with adequate shelter, many lack access to separate rooms where they can conduct an STI telehealth encounter privately.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Sexually transmitted infection programs will need to assess which patients are likely to benefit from telehealth services and tailor their programmatic efforts to reach and retain them 53 . Sexually transmitted infection telehealth services that fail to adapt to the linguistic differences and literacy challenges of patients, for example, or recognize the possible impact of patients' socioeconomic conditions on Internet access risk exacerbating health inequities 54–56 . Among persons experiencing homelessness, for example, telehealth service delivery, if it includes an audio-only option, can increase access to providers, but these services do not substitute for clinic-based social services and support 57 .…”

Section: Implications For Enhancing Sti Prevention Telehealth Servicesmentioning

confidence: 99%

Telehealth Services: Implications for Enhancing Sexually Transmitted Infection Prevention

2022

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In the United States, sexually transmitted infections (STIs) are among the most persistent threats to health equity. Increasing access to STI prevention and control services through the provision of Remote Health and Telehealth can improve sexual health outcomes. Telehealth has been shown to increase access to care and even improve health outcomes. The increased flexibility offered by Telehealth services accommodates both patient and provider. Although both Telehealth and Remote Health strategies are important for STI prevention, share common attributes, and, in some circumstances, overlap, this article will focus more specifically on considerations for Telehealth and how it can contribute to increasing health equity by offering an important complement to and, in some cases, substitute for in-person STI services for some populations. Telehealth assists a variety of different populations, including those experiencing STI disparities; however, although the Internet offers a promising resource for many American households and increasing percentages of Americans are using its many resources, not all persons have equal access to the Internet. In addition to tailoring STI programs to accommodate unique patient populations, these programs will likely be faced with adapting services to fit reimbursement and licensing regulations.

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System-Level Factors and Time Spent on Electronic Health Records by Primary Care Physicians

Rotenstein,

Holmgren,

Horn

et al. 2023

JAMA Netw Open

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ImportancePrimary care physicians (PCPs) spend the most time on the electronic health record (EHR) of any specialty. Thus, it is critical to understand what factors contribute to varying levels of PCP time spent on EHRs.ObjectiveTo characterize variation in EHR time across PCPs and primary care clinics, and to describe how specific PCP, patient panel, clinic, and team collaboration factors are associated with PCPs’ time spent on EHRs.Design, Setting, and ParticipantsThis cross-sectional study included 307 PCPs practicing across 31 primary care clinics at Massachusetts General Hospital and Brigham and Women’s Hospital during 2021. Data were analyzed from October 2022 to October 2023.Main Outcomes and MeasuresTotal per-visit EHR time, total per-visit pajama time (ie, time spent on the EHR between 5:30 pm to 7:00 am and on weekends), and total per-visit time on the electronic inbox as measured by activity log data derived from an EHR database.ResultsThe sample included 307 PCPs (183 [59.6%] female). On a per-visit basis, PCPs spent a median (IQR) of 36.2 (28.9-45.7) total minutes on the EHR, 6.2 (3.1-11.5) minutes of pajama time, and 7.8 (5.5-10.7) minutes on the electronic inbox. When comparing PCP time expenditure by clinic, median (IQR) total EHR time, median (IQR) pajama time, and median (IQR) electronic inbox time ranged from 23.5 (20.7-53.1) to 47.9 (30.6-70.7) minutes per visit, 1.7 (0.7-10.5) to 13.1 (7.7-28.2) minutes per visit, and 4.7 (4.1-5.2) to 10.8 (8.9-15.2) minutes per visit, respectively. In a multivariable model with an outcome of total per-visit EHR time per visit, an above median percentage of teamwork on orders was associated with 3.81 (95% CI, 0.49-7.13) minutes per visit fewer and having a clinic pharmacy technician was associated with 7.87 (95% CI, 2.03-13.72) minutes per visit fewer. Practicing in a community health center was associated with fewer minutes of total EHR time per visit (5.40 [95% CI, 0.06-10.74] minutes).Conclusions and RelevanceThere is substantial variation in EHR time among individual PCPs and PCPs within clinics. Organization-level factors, such as team collaboration on orders, support for medication refill functions, and practicing in a community health center, are associated with lower EHR time for PCPs. These findings highlight the importance of addressing EHR burden at a systems level.

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Not Speaking the Same Language—Lower Portal Use for Limited English Proficient Patients in the Los Angeles Safety Net

Cited by 11 publications

References 0 publications

The Internet as a social institution: Rethinking concepts for family scholarship

The Internet as a social institution: Rethinking concepts for family scholarship

Telehealth Services: Implications for Enhancing Sexually Transmitted Infection Prevention

System-Level Factors and Time Spent on Electronic Health Records by Primary Care Physicians

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