Use of Health Information Technology by Adults With Diabetes in the United States: Cross-sectional Analysis of National Health Interview Survey Data (2016-2018).

Seamus Y Wang,Arielle Apfel Stein,Hsin-Chieh Yeh,Edgar R Miller

doi:10.2196/27220

Abstract

BackgroundThe use of health information technology (HIT) has been proposed to improve disease management in patients with type 2 diabetes mellitus.ObjectiveThis study aims to report the prevalence of HIT use in adults with diabetes in the United States and examine the factors associated with HIT use.MethodsWe analyzed data from 7999 adults who self-reported a diabetes diagnosis as collected by the National Health Interview Survey (2016-2018). All analyses were weighted to account for the complex survey design.ResultsOverall, 41.2% of adults with diabetes reported looking up health information on the web, and 22.8% used eHealth services (defined as filled a prescription on the web, scheduled an appointment with a health care provider on the web, or communicated with a health care provider via email). In multivariable models, patients who were female (vs male: prevalence ratio [PR] 1.16, 95% CI 1.10-1.24), had higher education (above college vs less than high school: PR 3.61, 95% CI 3.01-4.33), had higher income (high income vs poor: PR 1.40, 95% CI 1.23-1.59), or had obesity (vs normal weight: PR 1.11, 95% CI 1.01-1.22) were more likely to search for health information on the web. Similar associations were observed among age, race and ethnicity, education, income, and the use of eHealth services. Patients on insulin were more likely to use eHealth services (on insulin vs no medication: PR 1.21, 95% CI 1.04-1.41).ConclusionsAmong adults with diabetes, HIT use was lower in those who were older, were members of racial minority groups, had less formal education, or had lower household income. Health education interventions promoted through HIT should account for sociodemographic factors.

Highlights

Advances in technologies have introduced mechanisms that support effective and affordable health care delivery and education
The aim of this study is to examine the prevalence of health information technology (HIT) use in adults with diabetes in the United States, compare it with the goals set in Healthy People 2020, and identify factors associated with HIT use by analyzing data from the National Health Interview Survey (NHIS; 2016-2018), which provides a large, nationally representative sample
41.2% of adults with diabetes looked up health information on the web, and 22.8% used eHealth services (14.7% filling a prescription on the web, 12.2% scheduling an appointment on the web, and 15% communicating with a health care provider via email)

Summary

Introduction

Background Advances in technologies have introduced mechanisms that support effective and affordable health care delivery and education. Web-based patient portals improve access to health information and personal health records These tools have shown promise, by improving glycemic control and reducing hemoglobin A1c levels, the effectiveness of these interventions at the population level is reliant on actual use by people with diabetes [2,3]. Healthy People 2020 specified the objectives of using health information technology (HIT) to improve population health outcomes and health care quality and to achieve health equity [1] These specific objectives included increasing the use of electronic personal health management tools (HIT Objective 5.1), increasing the use of the internet to communicate with their health providers (HIT Objective 5.2), and increasing web-based health information seeking (HIT Objective 9). The use of health information technology (HIT) has been proposed to improve disease management in patients with type 2 diabetes mellitus

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