Exploring the Digital Divide: Age and Race Disparities in Use of an Inpatient Portal
Exploring the Digital Divide: Age and Race Disparities in Use of an Inpatient Portal
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DOI：
10.1089/tmj.2019.0065
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发表时间：
2019-07-09
影响因子：
4.7
通讯作者：
McAlearney, Ann Scheck
中科院分区：
文献类型：
--
作者：
Walker, Daniel M.;Hefner, Jennifer L.;McAlearney, Ann Scheck
背景资料：年龄和种族在使用新技术方面的差异-数字鸿沟-可能限制了面向患者的健康信息技术改善健康和医疗保健的潜力。目的：调查是否存在差异，在使用专门为住院环境设计的患者门户网站。研究方法：2017年7月至2018年7月期间，在一家大型中西部学术医疗中心附属的六家医院住院的患者可以使用配备住院患者门户的平板电脑，并被招募参加研究（n = 842）。研究入组者的人口统计学特征来自患者的电子健康记录和患者住院期间的调查。使用住院患者门户网站的日志文件创建总体使用度量，并计算特定门户网站功能的使用率。结果：我们发现在使用住院门户网站的年龄和种族差异。60-69岁的患者（45.3%差异，p < 0.001）和70岁以上的患者（36.7%差异，p = 0.04）比18-29岁的患者更少使用住院入口。此外，非裔美国患者使用入路的次数少于白色患者（差异40.4%，p = 0.004）。讨论内容：这些研究结果表明，光有技术可能不足以克服使用障碍，可能需要采取额外的干预措施来缩小数字鸿沟。结论：我们发现非裔美国人和老年患者的住院患者门户网站使用率分别低于白色和年轻患者。
Background: Age and race disparities in the use of new technologies-the digital divide-may be limiting the potential of patient-facing health information technology to improve health and health care. Objective: To investigate whether disparities exist in the use of patient portals designed specifically for the inpatient environment. Methods: Patients admitted to the six hospitals affiliated with a large, Midwestern academic medical center from July 2017 to July 2018 were provided with access to a tablet equipped with an inpatient portal and recruited to participate in the study (n = 842). Demographic characteristics of study enrollees were obtained from patients' electronic health records and surveys given to patients during their hospital stay. Log files from the inpatient portal were used to create a global measure of use and calculate use rates for specific portal features. Results: We found both age and race disparities in use of the inpatient portal. Patients aged 60-69 (45.3% difference, p < 0.001) and those over age 70 (36.7% difference, p = 0.04) used the inpatient portal less than patients aged 18-29. In addition, African American patients used the portal less than White patients (40.4% difference, p = 0.004). Discussion: These findings suggest that the availability of the technology alone may be insufficient to overcome barriers to use and that additional intervention may be needed to close the digital divide. Conclusions: We identified lower use of the inpatient portal among African American and older patients, relative to White and younger patients, respectively.