Rural and Urban Differences in the Adoption of New Health Information and Medical Technologies

Abstract

Background: This statewide survey sought to understand the adoption level of new health information and medical technologies, and whether these patterns differed between urban and rural populations.Methods: A random sample of 7,979 people aged 18-75 years, stratified by rural status and race, who lived in 1 of 34 Indiana counties with high cancer mortality rates and were seen at least once in the past year in a statewide health system were surveyed.Results: Completed surveys were returned by 970 participants. Rural patients were less likely than urban to use electronic health record messaging systems (28.3% vs 34.5%, P = .045) or any communication technology (43.0% vs 50.8%, P = .017). Rural patients were less likely to look for personal health information for someone else's medical record (11.0% vs 16.3%, P = .022), look-up test results (29.5% vs 38.3%, P = .005), or use any form of electronic medical record (EMR) access (57.5% vs 67.1%, P = .003). Rural differences in any use of communication technology or EMRs were no longer significant in adjusted models, while education and income were significantly associated. There was a trend in the higher use of low-dose computed tomography (CT) scan among rural patients (19.1% vs 14.4%, P = .057). No significant difference was present between rural and urban patients in the use of the human papilloma virus test (27.1% vs 26.6%, P = .880). Conclusions:Differences in health information technology use between rural and urban populations may be moderated by social determinants. Lower adoption of new health information technologies (HITs) than medical technologies among rural, compared to urban, individuals may be due to lower levels of evidence supporting HITs.Key words cancer health services research, health behaviors, health care disparities, medical informatics, rural health.Rural patients previously diagnosed with cancer are more likely to report poor or fair health, psychological distress, and health-related unemployment. 1 Access to effective primary care is commonly gauged by lower rates of ambulatory care-sensitive hospitalizations, which are higher among adults living in rural areas. 2 To improve access, patient-centered technologies are increasingly incorporated as a component of health care delivery for patients to both communicate with their health care providers and access their electronic medical record (EMR). Patient-to-provider communication technologies are available both external and internal to the EMR

Communication About Health Information Technology Use Between Patients and Providers

“…The demographic profiles and generalizability of our study sample have been reported elsewhere. 9,10 In short, our study sample is largely consistent with estimates of the population. However, we mailed enough surveys to obtain a relatively large absolute number of surveys among rural and African-American individuals, two groups among whom we were concerned about the presence of disparities in access to health information technologies.…”

Comparison of Electronic Medical Records with Self-report in Measuring Cancer Screening

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