Abstract

Background: Some research has been done into using mobile phones as a means of communication with patients. It has been shown to improve medication adherence among chronically ill patients. As of December 2012 , more than 89% of the US inhabitants have mobile broadband subscriptions .This opens up the potential for Smartphone applications and also patient portals, above and beyond text messaging for patient communication. Objectives: To assess the readiness, interest and barriers of low income minority patients with diabetes mellitus (DM) and cardiovascular disease (CVD) towards adopting 1) Text messaging , Smartphone applications , Patient portals as means of communication with providers. 2)Compare technology adoption in immigrant versus non-immigrant populations. Methods: This study is part of the Office- Guidelines Applied to Practice (Office-GAP) project, designed to improve secondary prevention of heart disease for DM and CVD patients in FQHCs (Federally Qualified Health Centers) in Michigan. We analyzed 119 out of the 242 patients that participated in Office-GAP group visits (June 2013-January 2014) and completed the questionnaire. The questionnaire evaluated their readiness , interest and barriers towards electronic means of communication . Chart abstraction was performed for relevant data by trained research assistants. Descriptive analysis was performed on the cross sectional data thus obtained. Results: Study population is 53 % (63 of 119) non-immigrant , 47% (56 of 119) immigrant. Mean age is 53.69 (33.07% males) and 57.1% (68 of 119) of our patient population has a cellphone with non-immigrants having higher access (74.6 vs 37.5%) compared to immigrants. Text messages can be sent and received by 37.8% (45 of 119) with 21.1% (25 of 118) having to pay extra charges for texts and 25.7% (30 of 117) want texts from the doctors office. A landline is available to 54% (64 of 119) and 48.2% (56 of 116) want voicemails. Out of our population with both a landline and cellphone 57 %(60 of 106) prefer landline. Only 10 % (12 of 119) of our population can use a computer very well and 55% (65 of 119) cannot use a computer at all , 35%(42 of 119) have access to internet and email and 52.3%(22 of 42) want emails from their doctors office. Seven percent (4 of 58) would like to have access to their medical information online by means of a patient portal. Three percent (2 of 58) have a smartphone and 1.7% (1 of 58) would like a Smartphone application for accessing their medical records. Conclusion: Minority and low-income patients with DM and CVD may eventually be ready for adopting more technology as a means of communication with their provider as technology gets cheaper and trivialized . Current readiness and interest to adoption is lower among immigrant compared to non immigrant population. More research is needed to determine the barriers to adopting technology for secondary prevention of heart disease.

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