Identifying Differences in Communication Technology Preferences Across the Lifespan

Abstract

With the increasing use of technology in health care, providers must be aware of their patients' proficiency and preferences for the use of such resources.1 Although some studies have suggested the potential effects of technology on patient–physician relationships in specialists' offices, there is scant evidence on its use and patient preferences in the primary care setting.2-5 It is important to understand how best to use available technologies within the medical system. Provider awareness of patient abilities and preferences, along with better patient access to healthcare information, leads to overall better health outcomes,6-10 yet more information is needed before it will be possible to develop an advanced medical system that successfully integrates current technologies with the concept of a patient-centered medical home. A survey was designed to determine what forms of technology people currently use and what health information technology they prefer to use for future communication. Individuals who presented for primary care office visits were surveyed. The survey consisted of an anonymous two-page questionnaire. The first page assessed the participant's age, sex, and current use of various technologies (e.g., cell phone, internet, social networking). The second page surveyed interest in using these technologies in a variety of settings (scheduling appointments, asking for refills, accessing personal medical information). Five hundred thirty-four people completed the surveys, including 130 who were older, 240 middle aged, and 164 younger. In terms of current use of technology, older adults used every surveyed technology significantly less than middle-aged and younger adults, although the majority of older adults indicated that they used internet, e-mail, and cellular telephones (50%, 54%, and 75%, respectively). When communicating with their primary care office, older adults indicated a preference for landline telephone use (Figure 1). Finally, when asked to indicate how they would use these technologies, no significant differences were seen between the age groups. As had been hypothesized, older adults not only differed from younger adults in their current use of technology, but they also preferred different ways to interact with their doctor's office. For each modern technological modality surveyed, older adults were less likely to use it than younger adults. Understandably then, older adults were more hesitant to accept some of these modalities as a means to communicate with their primary care physicians than the more technologically savvy younger adults. Although less technologically capable than younger populations, the majority of older adults indicated that they used cellular telephones, the internet, and e-mail. Perhaps because they learned these modalities later in life, older adults do not feel comfortable using them to contact their doctor; younger adults who grew up with these technologies are more likely to trust them with their medical information. When asked how they would use the surveyed technologies, the different age groups responded similarly. The only service that each group chose against was access to their medical chart, which signals that, although older adults may feel more comfortable with traditional means of communication, to some degree, everyone is skeptical of their primary care offices overstepping boundaries with regard to technology. As providers begin to develop the concept of the patient-centered medical home, it is important to keep their patients' wishes in mind. If older adults still prefer a traditional means of communicating with their primary care doctors, perhaps practices with older-adult populations should dedicate more resources to perfecting landline communication with their patients. Practices with younger populations would probably experience an easier transition into a technologically advanced medical home and may consider investing in e-mail or internet services. Finally, the survey exemplified willingness to participate in the discussion of an advanced medical home. Hundreds of surveys were collected in a short period of time by simply asking people for their preferences. It is a step that primary care practices should include in the process of transforming the medical home. Conflict of Interest: MS is sponsored in kind under an unrelated Health Resources and Services Administration grant and through an American Academy of Family Physicians stipend provided for salary support to the Department of Family and Community Medicine for participation in their Vaccine Science Fellowship. MS is a board member for the Southeast Pennsylvania Health Education Council and the Delaware Academy of Family Physicians. All resources were available through Christiana Care Health System without funding. Author Contributions: Weinberg, Guarino, Savoy, Horton, and Reed: study concept, study design, acquisition of subjects, data interpretation, and manuscript preparation. Reed: data analysis. Sponsor's Role: None.