Abstract
BackgroundCommunication is key in chronic disease management, and the internet has altered the manner in which patients and providers can exchange information. Adoption of secure messaging differs among patients due to the digital divide that keeps some populations from having effective access to online resources.ObjectiveThis study aimed to examine the current state of online patient-provider communication, exploring trends over time in the use of online patient-provider communication tools.MethodsA 3-part analytic process was used to study the following: (1) reanalysis, (2) close replication across years, and (3) trend analysis extension. During the reanalysis stage, the publicly available Health Information National Trends Survey (HINTS) 1 and 2 data were used with the goal of identifying the precise analytic methodology used in a prior study, published in 2007. The original analysis was extended to add 3 additional data years (ie, 2008, 2011, and 2013) using the original analytical approach with the purpose of identifying trends over time. Multivariate logistic regression was used to analyze pooled data across all years, with year as an added predictor, in addition to a model for each individual data year.ResultsThe odds of internet users to communicate online with health care providers was significantly and increasingly higher year-over-year, starting in 2003 (2005: odds ratio [OR] 1.31, 95% CI 1.03-1.68; 2008: OR 2.14, 95% CI 1.76-2.59; 2011: OR 2.92, 95% CI 2.33-3.66; and 2013: OR 5.77; 95% CI 4.62-7.20). Statistically significant socio-economic factors found to be associated with internet users communicating online with providers included age, having health insurance, having a history of cancer, and living in an urban area of residence.ConclusionsThe proportion of internet users communicating online with their health care providers has significantly increased since 2003. Although these trends are encouraging, access challenges still exist for some groups, potentially giving rise to a new set of health disparities related to communication.
Highlights
Effective communication between a patient and their health care provider is central to the provision of medical care [1,2,3]
The new communication channels can reduce access burdens related to navigating the care system, including the transaction costs associated with seeking care
Health Information National Trends Survey (HINTS) is a dataset that is maintained by National Cancer Institute and does include several questions that focus on cancer, the population surveyed is random and many of the questions relate to general health communication
Summary
Effective communication between a patient and their health care provider is central to the provision of medical care [1,2,3]. The trust it can build, chronic disease management can be tenuous and the delivery of high quality care is impaired [4], medication adherence is reduced, and patients rely on low-quality information for making decisions that affect their health [5]. The internet has transformed the way people communicate, providing alternative means of communication (eg, email, secure messaging, instant messaging, and online videos) that supplement or, in some instances, have replaced the traditional in-person and telephonic communications. These alternative communication channels are being utilized with greater frequency and are becoming a normal part of service delivery in the health care industry. Adoption of secure messaging differs among patients due to the digital divide that keeps some populations from having effective access to online resources
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