Journal Article

The Digital Divide at an Urban Community Health Center: Implications for Quality Improvement and Health Care Access

Stevens, Sheila F., Miller, David P., Wofford, James L., Denizard-Thompson, Nancy M., Feiereisel, Kirsten B.

2011

Overview

Health care policy encourages better electronic connectivity between patient and the office practice. However, whether patients are able to partner with the practice in using communication technologies is not known. We sought to determine (1) the proportion of clinic patients who use internet and cell phone text messaging technologies, (2) the level of patient interest in using these technologies for the purpose of managing clinical appointments and patient education. Consecutive adult patients, clinicians and staff at an urban community health center were surveyed during a one-week period in order to estimate the frequency of technology use by patients. A total of 308 survey cards were collected during the designated week (response rate of 85% (308/362). One-third (34.0%, 105) of surveyed patients used the internet and text messaging daily or weekly, while nearly two-thirds (59.7%, 182) never used these technologies. There were no racial or gender differences in the proportion of patients who used the internet daily or weekly. In contrast, AfricanAmericans used text messaging more often than whites (28.2 vs. 21.4%, P < .05), and females more than males (30.8 vs. 18.5%, P < .05). Younger patients (>50) used the internet and text messaging more often than older patients (50.6 vs. 16.6%, 44.3 vs. 7.3%, respectively). Despite the low use of both technologies, patient's interest in managing clinic appointments was high (40.3% for the Internet and 56.8% for text messaging). Clinicians and staff estimated patient's daily/weekly use of internet and cellphone messaging at 40.3% (±22.0), and 56.8% (±25.7), respectively. Most patients at this urban community health center reported never using the internet or cell phone text messaging. Clinicians overestimated technology use by patients. Planning for clinic infrastructure, quality improvement, and patient education should include assessment of technology use patterns by patients.

• Publisher: Springer Science + Business Media, LLC,Springer US,Springer Nature B.V
• Subject: Access / Access to Computers / Access to Information / Adolescent / Adult / African Americans / African Americans - statistics & numerical data / Aged / Aged, 80 and over / Appointments and Schedules / Cell Phone - utilization / Communication (Thought Transfer) / Communications technology / Community / Community and Environmental Psychology / Community Health Centers - organization & administration / Community health services / Community Relations / Computer Assisted Instruction / Computers / Data Collection / Distance Education / Education / Educational Technology / Ethics / European Continental Ancestry Group - statistics & numerical data / Female / Focus Groups / Gender differences / Health care / Health care access / Health care policy / Health Care Services / Health education / Health facilities / Health policy / Health Promotion and Disease Prevention / Health services / Health Services Accessibility / Humans / Information Dissemination - methods / Infrastructure / Internal Medicine / Internet / Internet - utilization / Internet access / Male / Medical personnel / Medicine / Medicine & Public Health / Middle Aged / Mobile phones / ORIGINAL PAPER / Patient appointments / Patient education / Patient Education as Topic - methods / Patients / Physicians / Polls & surveys / Public Health / Quality Improvement / Quality management / Quality of care / Quality of Health Care / Racial differences / Sex Factors / Statistical Analysis / Technology assessment / Telecommunications / Telemedicine / Telephones / Text messaging / Urban Areas / Urban health care / Urban Health Services - organization & administration / Whites / Young Adult