Electronic Communication Technology Use Among Texas Primary Care - - PowerPoint PPT Presentation

JASON HILL MS, SANDRA BURGE PHD, ANNA HARING UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER SAN ANTONIO, TX

Electronic Communication Technology Use Among Texas Primary Care Patients:

An RRNeT Study

Question:

I wonder how many of our patients have cell phones? computers? internet service?

RRNeT: Residency Research Network

• f Texas

Americans’ Access to Electronic Communication

• The Pew Research Center (2011) described

access to cell phones, computers and Internet.

• 88% of Americans have a cell phone
• 57% have a laptop
• 78% use the internet
• Older people are less likely to use the internet than

younger people (41% versus 94%)

• Low income people are less likely to use the

internet than high income people (62% versus 97%)

Patient Centered Medical Home

• Part of being “patient‐centered” means

increasing access to health care, including electronic access to health information.

• Practices are rewarded for:
• Using e‐mail systems and text messaging to

communicate health information to patients.

• Creating web portals whereby patients can

communicate with physicians in real time.

• Creating websites where health information can

be communicated to patients.

What Do Patients Want? What Can Patients Use?

• Are our low‐income minority patients

‘connected’?

• Do they want to use electronic devices for

communicating health information?

Study Purpose

• To evaluate primary care patients’ access

to, use of, and preferences for cell phones and computers for communicating health information

• To examine differences in access, use, and

preferences based on gender, age, race/ ethnicity, and insurance status

METHODS

Methods

• Subject Recruitment



Summer 2011



During 5 to 8 clinic half‐day sessions per week,



Medical Student research assistants randomly selected a physician,



And invited all his/ her adult patients to complete a survey



This study had IRB approval from 9 hospitals & 2 universities

Methods

• Measurement
• 1 page anonymous survey



Patient demographics



Access to telephones, cell phones, home computers, internet



Use of electronic devices



Preferences for sending and receiving health information via electronic modalities.

Methods

• Analysis



Chi square tests examined group differences in technology access, use and preferences



Groups were defined by gender, age, insurance status, and race/ethnicity.



Health insurance status was considered an estimate for socioeconomic status

RESULTS

533 Adult Patients

52% 31% 13% 4% Ethnicity/ Race

Latino Caucasian African American Other

33% 67% Gender

Males Females

533 Adult Patients

26% 21% 23% 20% 5% 5%

Insurance Type

Private Medicare Medicaid County Plan Self Pay Unknown

27% 52% 21%

Age

Young Adults [21 ‐ 39 yrs] Middle Age [40 ‐ 64 yrs] Seniors [65 + yrs]

Basic Access

• 97% have a telephone
• 84% have a cell phone

 53% use texting  38% have month‐to‐month contracts  18% changed phone number in past year

• 62% own a computer
• Few differences between women and men

 Men more likely to have cell phone  Men more likely to own a computer

Access

533 510 440 200 325 17 93 240 208

100 200 300 400 500 600 Subjects Own a Phone Own a Cell Phone Monthly Contract Computer at Home yes no

Use

440 280 325 259 253 167 131 160 66 72 158 194

100 200 300 400 500 Own Cell Phone Use Texting Computer at Home Use Internet Use Email Use Facebook View YouTube yes no

Preferences

533 107 100 200 189 67 72 174 181 53 64 192 187 100 200 300 400 500 Total Sample send health info by text receive health info by text send health info by email receive health info by email send health info by internet receive health info by internet yes no

Age Differences in Access & Use

0% 20% 40% 60% 80% 100% Cell Phone Texting Computer Internet Search Email Facebook Young Adults Middle Age Seniors

All comparisons, p=.000

Insurance Status by Access & Use

0% 20% 40% 60% 80% 100% Cell Phone Texting Computer Internet Search Email Facebook Private Medicare Medicaid Other

All comparisons, p=.000

Race/Ethnicity by Access & Use

0% 20% 40% 60% 80% 100% Cell Phone Texting Computer Internet Search Email Facebook Latinos Caucasians African Amer p=.024 p=.000 p=.000 p=.000 p=.008 ns

Age Differences in Preferences

0% 20% 40% 60% 80% 100% send by text receive by text send by email receive by email send by internet receive by internet Young Adults Middle Age Seniors

All comparisons, p≤.005

Would you like sending/ receiving your health information by…?

Insurance Status by Preferences

0% 20% 40% 60% 80% 100% send by text receive by text send by email receive by email send by internet receive by internet Private Medicare Medicaid Other

Most comparisons, p ≤ .005

ns Would you like sending/ receiving your health information by…?

Race/Ethnicity by Preferences

0% 20% 40% 60% 80% 100% send by text receive by text send by email receive by email send by internet receive by internet Latinos Caucasians African Amer ns p=.006 p=.000 ns ns ns

Would you like sending/ receiving your health information by…?

CONCLUSIONS

Conclusions

• Almost everybody has a phone (97%)
• The people with greatest access to and use of

electronic communication technology are:

 Younger  Caucasian  With private health insurance

Conclusions

• Our patients are less likely to have internet

access, compared to the Pew Research Study

 (50% versus 78%)

• Few patients want to send or receive health

information electronically

 E‐mail was most acceptable mode  36% ‐ 38%

Conclusions

• For many, “high touch” communication is

preferred to “high‐tech”

• To be patient‐centered, practices need to

ASK PATIENTS about their preferences for:

 Health care access  Communication of health information

High Touch!