Consumer Health Informatics Adoption among Underserved Populations: Thinking beyond the Digital Divide

Huh, Jina; Koola, Jejo D.; Contreras, Alejandro; Castillo, Alanah Kp.; Ruiz, Melissa; Tedone, Keely G.; Yakuta, Melissa; Schiaffino, Melody K.

doi:10.1055/s-0038-1641217

Cited by 58 publications

(47 citation statements)

References 59 publications

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“…Although the use of technology may overcome some of these barriers, these methods may be limited by access and familiarity to newer devices especially in vulnerable populations. 24 , 25 At the OSUWMC, patients are now offered tablets with built-in video chat capabilities; many hospitals have created similar “virtual visitor” programs. Third, because patients perceived that timely access to medications and walking assistance was affected by the lack of visitors, hospitals should make changes to adjust for this deficiency.…”

Section: Discussionmentioning

confidence: 99%

Impact of visitor restriction rules on the postoperative experience of COVID-19 negative patients undergoing surgery

Zeh

Santry

Monsour

et al. 2020

Surgery

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Background Many hospitals have implemented visitor restriction policies in response to the coronavirus disease 2019 pandemic. Because caregivers serve an important role in postoperative recovery, the purpose of this study was to evaluate the impact of visitor restrictions on the postoperative experience of coronavirus disease 2019-negative patients undergoing surgery. Methods Patients who underwent surgery immediately before or after the implementation of a visitor restriction policy were enrolled. Patients were surveyed on their inpatient experience and preparedness for discharge using items adapted from validated questionnaires. Results Among 128 eligible patients, 117 agreed to participate (91.4% response rate): 58 (49.6%) in the Visitor Cohort and 59 (50.4%) in the No-Visitor Cohort. Mean age was 57.5 years (standard deviation 13.9) and 66 (56.4%) were female. Among all patients, 47.8% underwent oncologic surgery, 31.6% transplant, and 20.5% general or other. Patients in the No-Visitor Cohort were less likely to report complete satisfaction with the hospital experience (80.7% vs 66.0%, P = .044), timely receipt of medications (84.5% vs 69.0%, P = .048), and assistance getting out of bed (70.7% vs 51.7%, P = .036). No-Visitor Cohort patients were less likely to feel that their discharge preferences were adequately considered (79.3% vs 54.2%, P = .004). Qualitative analysis of patient responses highlighted the consistent psychosocial support provided by visitors after surgery (84.5%), and patients in the No-Visitor Cohort reported social isolation due to lack of psychosocial support (50.8%). Conclusion The implementation of hospital visitor restriction policies may adversely impact the postoperative experience of coronavirus disease 2019-negative patients undergoing surgery. These findings highlight the urgent need for novel patient-centered strategies to improve the postoperative experience of patients during ongoing or future disruptions to routine hospital practice.

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Section: Discussionmentioning

confidence: 99%

Impact of visitor restriction rules on the postoperative experience of COVID-19 negative patients undergoing surgery

Zeh

Santry

Monsour

et al. 2020

Surgery

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“…Around late March/early April 2020, the implementation of telemedicine services to meet patient demand drastically increased in response to the COVID-19 pandemic, which has reached 92,262,621 cases in 223 countries as of January 16, 2021 [9][10][11]. Historically, however, there has been a "digital divide" in which underserved populations lack access to computers and the internet, thereby serving as a significant barrier to care management utilizing HIT [12]. In recent years, mobile phones have helped in bridging this divide.…”

Section: Introductionmentioning

confidence: 99%

Health Information Technology Use Among Persons With Self-reported Atherosclerotic Cardiovascular Disease: Analysis of the 2011-2018 National Health Interview Survey

Nwokeji¹,

Spaulding²,

Shan³

et al. 2021

J Med Internet Res

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Background Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in the United States. Health information technologies (HITs) have recently emerged as a viable intervention to mitigate the burden of ASCVD. Approximately 60% of US adults report searching the internet for health information; however, previous research has not examined the prevalence of general technology or HIT use among adults with and without ASCVD. In addition, social determinants in HIT use among adults with ASCVD are not well understood. Objective The aim of this study was to evaluate the prevalence and social determinants of HIT use among US adults with versus without self-reported ASCVD. Methods We pooled cross-sectional data from the 2011-2018 National Health Interview Survey (NHIS) to examine the general technology and HIT use among adults aged ≥18 years with and without self-reported ASCVD (coronary heart disease, stroke, or both). General technology use was defined as mobile phone ownership, internet use, and computer use. HIT use was defined as looking up health information on the internet, filling a web-based prescription, scheduling a medical appointment on the internet, communicating with a health care provider by email, or using web-based group chats to learn about health topics. We evaluated sociodemographic differences in HIT use among respondents by using Poisson regression. Analyses were weighted according to NHIS standards. Results A total sample of 256,117 individuals were included, of which 2194 (0.9%) reported prior ASCVD. Among adults with prior ASCVD, the mean age was 70.6 (SD 11.5) years, and 47.4% (1048/2194) of the adults were females. General technology use differed between participants with and without prior ASCVD, with 36.0% (614/1826) and 76.2% (157,642/213,816) indicating internet usage and 24.6% (374/1575) and 60.7% (107,742/184,557) indicating using a computer every day, respectively. Similarly, adults with ASCVD were less likely to use HIT than those without ASCVD (515/2194, 25.1% vs 123,966/253,923, 51.0%; P<.001). Among adults with prior ASCVD, social determinants that were associated with HIT use included younger age, higher education, higher income, being employed, and being married. Conclusions HIT use was low among adults with a history of ASCVD, which may represent a barrier to delivering care via emerging HIT. Given the associations with social determinants such as income, education, and employment, targeted strategies and policies are needed to eliminate barriers to impact HIT usage.

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“…The new advances in diabetes technology combined with making these accessible to all, but in particular to the lower SES population, can remedy this issue. In addition, the outreach of media devices, such as cellphones, for use in telemedicine could also contribute to levelling the field treatment-wise since the penetration of digital devices is increasing exponentially in all socioeconomical and sociocultural levels [32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Social Inequality and Diabetes: A Commentary

Barnard‐Kelly

Cherñavvsky

2020

Diabetes Ther

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Socioeconomic inequality of access to healthcare is seen across the spectrum of healthcare, including diabetes. Health inequalities are defined as the 'preventable, unfair and unjust differences in health status between groups, populations or individuals that arise from the unequal distribution of social, environmental and economic conditions within societies, which determine the risk of people getting ill, their ability to prevent sickness or opportunities to take action and access treatment when ill health occurs' (NHS England; https://www. england.nhs.uk/about/equality/equality-hub/re sources/). Access to diabetes technologies has improved glycaemic and quality-of-life outcomes for many users. Inability to access such devices, however, is evidenced in National Diabetes Audit data, with a reported tenfold variation in insulin pump use by people with type 1 diabetes across specialist centres. This variation suggests a lack of access to healthcare systems that should be investigated. This article highlights some of the key issues surrounding healthcare inequalities in the management of diabetes.

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Consumer Health Informatics Adoption among Underserved Populations: Thinking beyond the Digital Divide

Cited by 58 publications

References 59 publications

Impact of visitor restriction rules on the postoperative experience of COVID-19 negative patients undergoing surgery

Impact of visitor restriction rules on the postoperative experience of COVID-19 negative patients undergoing surgery

Health Information Technology Use Among Persons With Self-reported Atherosclerotic Cardiovascular Disease: Analysis of the 2011-2018 National Health Interview Survey

Social Inequality and Diabetes: A Commentary

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