Bridging the Digital Divide

Mobile Access to Personal Health Records Among Patients With Diabetes

Ilana Yonas, Jie Huang, Richard J. Brand, John Hsu, Cyrus K. Yamin, Mary E. Reed

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVES: Some patients lack regular computer access and experience a digital divide that causes them to miss internet-based health innovations. The diffusion of smartphones has increased internet access across the socioeconomic spectrum, and increasing the channels through which patients can access their personal health records (PHRs) could help bridge the divide in PHR use. We examined PHR use through a computer-based Web browser or mobile device. STUDY DESIGN: Cross-sectional historical cohort analysis. METHODS: Among adult patients in the diabetes registry of an integrated healthcare delivery system, we studied the devices used to access their PHR during 2016. RESULTS: Among 267,208 patients with diabetes, 68.1% used the PHR in 2016; 60.6% of all log-ins were via computer and 39.4% were via mobile device. Overall, 63.9% used it from both a computer and mobile device, 29.6% used only a computer, and 6.5% used only a mobile device. After adjustment, patients who were black, Hispanic, or Asian; lived in lower socioeconomic status (SES) neighborhoods; or had lower engagement were all significantly more likely to use the PHR only from a mobile device (P <.05). Patients using the PHR only via mobile device used it less frequently. CONCLUSIONS: Mobile-ready PHRs may increase access among patients facing a digital divide in computer use, disproportionately reaching racial/ethnic minorities and lower SES patients. Nonetheless, even with a mobile-optimized and app-accessible PHR, differences in PHR use by race/ethnicity and SES remain. Continued efforts are needed to increase equitable access to PHRs among patients with chronic conditions.

Original languageEnglish (US)
Pages (from-to)43-48
Number of pages6
JournalAmerican Journal of Managed Care
Volume24
Issue number1
StatePublished - Jan 1 2018

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Personal Health Records
Equipment and Supplies
Social Class
Internet
Digital Divide
Web Browser
Mobile Applications
Integrated Delivery of Health Care
Delivery of Health Care
Hispanic Americans
Registries
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Bridging the Digital Divide : Mobile Access to Personal Health Records Among Patients With Diabetes. / Yonas, Ilana; Huang, Jie; Brand, Richard J.; Hsu, John; Yamin, Cyrus K.; Reed, Mary E.

In: American Journal of Managed Care, Vol. 24, No. 1, 01.01.2018, p. 43-48.

Research output: Contribution to journalArticle

Yonas, Ilana ; Huang, Jie ; Brand, Richard J. ; Hsu, John ; Yamin, Cyrus K. ; Reed, Mary E. / Bridging the Digital Divide : Mobile Access to Personal Health Records Among Patients With Diabetes. In: American Journal of Managed Care. 2018 ; Vol. 24, No. 1. pp. 43-48.
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abstract = "OBJECTIVES: Some patients lack regular computer access and experience a digital divide that causes them to miss internet-based health innovations. The diffusion of smartphones has increased internet access across the socioeconomic spectrum, and increasing the channels through which patients can access their personal health records (PHRs) could help bridge the divide in PHR use. We examined PHR use through a computer-based Web browser or mobile device. STUDY DESIGN: Cross-sectional historical cohort analysis. METHODS: Among adult patients in the diabetes registry of an integrated healthcare delivery system, we studied the devices used to access their PHR during 2016. RESULTS: Among 267,208 patients with diabetes, 68.1{\%} used the PHR in 2016; 60.6{\%} of all log-ins were via computer and 39.4{\%} were via mobile device. Overall, 63.9{\%} used it from both a computer and mobile device, 29.6{\%} used only a computer, and 6.5{\%} used only a mobile device. After adjustment, patients who were black, Hispanic, or Asian; lived in lower socioeconomic status (SES) neighborhoods; or had lower engagement were all significantly more likely to use the PHR only from a mobile device (P <.05). Patients using the PHR only via mobile device used it less frequently. CONCLUSIONS: Mobile-ready PHRs may increase access among patients facing a digital divide in computer use, disproportionately reaching racial/ethnic minorities and lower SES patients. Nonetheless, even with a mobile-optimized and app-accessible PHR, differences in PHR use by race/ethnicity and SES remain. Continued efforts are needed to increase equitable access to PHRs among patients with chronic conditions.",
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