Background/Purpose:

Use of the Internet and mobile technologies  can be a valuable resource for patients with rheumatic diseases who are seeking health-related information, allowing patients to track health longitudinally, and/or engage with similar patients or their clinicians. However, such technologies may have a limited penetrance among certain demographic groups defined by older age, non-Caucasian race, and lower education and income. We evaluated use and ownership of information technologies among patients in a  rheumatology clinic to assess their use of these technologies, and assess any differences based on patients’ characteristics.

Methods:

Starting in 2014 (with ongoing recruitment ), we approached adult patients from two rheumatology outpatient clinics at a large academic medical center to participate in a descriptive survey, administered either on paper or electronically (iPad tablet) according to patient preference. The survey included questions derived from the Pew Internet Survey regarding 1) ownership of a smartphone; 2) use of  the Internet for health-related information in the last 12 months; and 3) willingness to electronically exchange medical information with their healthcare provider. Additional data included information about demographics and socioeconomic status. These three outcomes were examined according to various demographic and socioeconomic status (SES) categories. 

Results

Among 195 patients approached to take the survey, 171 (87%) completed the survey, 24 (12%) refused, and 2 (1%) failed to complete it. Among complete responders, 82% were women, 75% were white, with median age 56 years, and 77% had at least some college education. The gender and race distribution was similar between respondents and those who refused.

Age older than 65, lower education, and lower income were associated with less smartphone ownership, less use of the Internet for health-related reasons, and a lower willingness to share electronic health information with their healthcare provider (Table). In contrast, sex and race were not strongly associated with these outcomes. However, even for patient groups with less access to or use of technologies for health reasons, more than 50% of patients reported ownership or willingness to use IT.

Conclusion

Based upon this sample of rheumatology patients, older age, lower education and lower household income were associated with less use of the Internet and information technology for health reasons. However, at least half of patients in these demographic and SES categories had access to these technologies. Given these results, it is reasonable to expect that technolgical solutions that address the health information needs of patients with rheumatic diseases can reach a broad patient population.

Table: Factors associated with Healthcare-related Internet use and Technology

*=   p-value =<0.05

~= p-value <0.0001