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Electronic Health Information Access & Use: A Divide Across Sociodemographic Characteristics

Lindsey Teal, Dr. Katelyn Jetelina

The University of Texas at Austin Dell Medical School


Introduction: Modern electronics and technology has transformed medicine by allowing rapid communication between clinical care teams and patients. However, electronic medical record (EMR) and technology access disparities may differentially prevent patients from benefitting from these resources.

Methods: Data was analyzed from the cross-sectional, nationally representative Health Information National Trends Survey 5 Cycle 2 (2018). Adults were asked to self-report online medical records access, use, and sociodemographics. Adults were also asked to list reasons for no EMR use. Logistic regression models determined the odds of EMR access and use across sociodemographics.

Results: Of the 3,504 patients surveyed, 58% had access to an online medical record. The odds of having access to an online medical record were higher among groups with higher income (OR= 6.76; 95% CI) and level of education (OR= 6.04, 95%CI), younger age (OR= 5.67 95%CI), female (OR= 1.31, 95%CI), White Non-Hispanic (OR= 1.66, 95%CI), and greater perception of general health (OR= 1.41, 95%CI). Of patients with access, 60% had used the EMR at least once within the last 12 months. EMR use was reported significantly more frequently by groups with higher income and level of education, younger age, and greater perception of general health. The odds of no internet access being the reason for no EMR use was higher in groups with lower income (OR= 4.12, 95%CI), and education (OR= 17.14, 95%CI), higher age (OR= 7.03 95%CI), and poorer perception of general health (OR= 1.66, 95%CI).

Conclusion: EMRs are used by many patients to rapidly communicate with providers, refill prescriptions, and download health information to personal electronic devices. However, lack of access to EMR significantly limits these services consistently across several low income minority groups. Future efforts should increase the access and use of EMR, possibly through education and economic incentives for clinics and physicians, to benefit all patients.

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