Monday, March 7, 2016

Disparities in Individuals' Access and Use of Health Information Technology

ONC Data Brief 34, published last month, examined the disparities in individuals’ access and use of health information technology in 2014. Findings from nationally representative surveys show that individuals' use of information technology (IT) for health needs increased significantly between 2013 and 2014. Prior analysis revealed that disparities in online access of medical records and use of IT for health-related needs existed by certain socio-demographic characteristics and geographic settings in 2013.

The data reveal 5 major trends:

1.       Individuals whose provider had an EHR were offered online access to their medical record at three times the rate of those whose provider does not. In 2014, individuals whose provider had an EHR had significantly higher rates of using IT for health needs compared to individuals whose provider did not have an EHR. The percent of individuals offered access to online medical records, emailing providers, and looking up test results online increased between 2013 and 2014; however, the rate of increase was greater among those whose provider had an EHR.
2.      Individuals with lower incomes and less education had significantly lower rates of being offered online access to their health information. While about half of individuals with incomes of $100,000 or more were offered online access to their health information, only about one-quarter of individuals with less than a $25,000 annual income were offered online access. Individuals with more than a four year college degree were offered online access at about twice the rate as individuals who had a high school degree or less.
3.      Individuals who had difficulty speaking English were offered online access to their medical records at significantly lower rates. While 39% of individuals who spoke English very well or well were offered online access to their medical record, only 15% of individuals who didn't speak English well and only 5% of those who didn't speak English at all were offered online access to their medical record. Almost twice as many white, non-Hispanic individuals were offered online access to their medical record as compared to Hispanic individuals.
4.      Among individuals offered online access to their medical record, those with higher incomes and more education were more likely to view their record. Individuals with annual incomes of at least $50,000 had significantly higher rates of viewing their online medical record compared to individuals with incomes less than $25,000. While almost two-thirds of individuals with annual incomes higher than $100,000 viewed their online medical record at least once within the past year, only about one-third of individuals with incomes less than $25,000 viewed their record within the past year. Individuals with a high school degree or less had significantly lower rates of viewing their online medical record compared to individuals with more than a four-year college degree. Individuals with a four-year college degree or more education were over twice as likely to view their online medical record compared to those without a high school degree.
5.      Individuals with more education and higher income use certain types of IT for health-related needs at significantly higher rates. Individuals 50-59 years of age had significantly higher rates of text-messaging and emailing their provider, looking up online test results, and using a mobile health application compared to individuals 70 years or older. Individuals with no disabilities had significantly higher rates of emailing their provider and using a mobile health application than individuals with a disability. Individuals residing in rural areas have significantly lower rates of emailing their provider, looking up test results online and using a smart phone health application compared to individuals residing in suburban settings.

What do you make of the results? Do your experiences with patients reflect the data above? Let us know in the comments below.

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