Bridging the Digital Divide: Reaching Vulnerable Populations

Abstract

The AMIA 2003 Spring Congress entitled "Bridging the Digital Divide: Informatics and Vulnerable Populations" convened 178 experts including medical informaticians, health care professionals, government leaders, policy makers, researchers, health care industry leaders, consumer advocates, and others specializing in health care provision to underserved populations. The primary objective of this working congress was to develop a framework for a national agenda in information and communication technology to enhance the health and health care of underserved populations. Discussions during four tracks addressed issues and trends in information and communication technologies for underserved populations, strategies learned from successful programs, evaluation methodologies for measuring the impact of informatics, and dissemination of information for replication of successful programs. Each track addressed current status, ideal state, barriers, strategies, and recommendations. Recommendations of the breakout sessions were summarized under the overarching themes of Policy, Funding, Research, and Education and Training. The general recommendations emphasized four key themes: revision in payment and reimbursement policies, integration of health care standards, partnerships as the key to success, and broad dissemination of findings including specific feedback to target populations and other key stakeholders.

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

“…The digital divide threatens to further harm the health of these vulnerable populations by excluding them from the benefits of internetbased communication with their health care provider. [20][21][22] Understanding and advancing the use of health information technology among vulnerable populations has therefore been identified as a national research and policy priority. 12,13 Moreover, there is evidence of a 'digital divide' in the U.S., particularly an inequity in internet access for those with fewer economic and social resources.…”

Health Literacy and the Digital Divide Among Older Americans

“…[7][8][9] Vulnerable groups such as African-Americans or those with low socioeconomic status are less likely to use EMRs or patient portals, [9][10][11][12][13][14][15][16] in part because they are less likely to use the Internet at all. [17][18][19][20] Health literacy may also play an important role in determining whether elderly patients are willing and able to use EMRs and other Internet-based health tools. Surprisingly, given the substantial body of research that documents the importance of health literacy in health behaviors and outcomes, [21][22][23] it has been largely overlooked as a determinant of health IT use.…”

Does Personality Matter When We Are Sick? An Empirical Study of the Role of Personality Traits and Health Emotion in Healthcare Technology Adoption Decision

“…In summary, although studies, such as Chang et al [19], reported patients' individual characteristics can interact with technology to contribute to vulnerability, which potentially influence their technology usage behavior, no study to date investigated the influence of individual characteristics such as personality traits on individuals' patient portal usage behavior. In addition, although the importance of health emotion in technology adoption behavior emerged in recent years [22,23], the impact of this factor on patient portal use is still unexplored and remained unknown.…”

“…A review of technology adoption literature [15][16][17][18] suggests that individuals' personality traits are also important in influencing technology adoption behavior. Chang et al [19] stated that patients' individual characteristics can interact with technology, which potentially influence their technology usage behavior. Dispositional factors, such as individuals' personality traits, that are mostly counted in Education, Organizational Behavior, and Human Psychology disciplines are left largely unexplored in Information Technology (IT) literature [20].…”