JMIR Publications

ABSTRACT

Background:

Online medical records are being used to organize processes in clinical and outpatient settings and to forge doctor-patient communication techniques to build mutual understanding and trust.

Objective:

This paper aims to understand the reasons why patients tend to avoid using online medical records and to compare the perceptions different patients have of online medical records based on demographics and cancer diagnosis using a nationally representative survey.

Methods:

We used data from the Health Information National Trends survey pooled HINTS 5 Cycle 3 data and assessed outcomes using descriptive statistics and chi-square tests. The 4328 patients included in the analysis had experienced an outpatient visit within the previous 12 months and answered the online behavior question regarding their use of online medical records.

Results:

Patients who are non-users of online medical records consisted 58.36% of the participants. The results show that the majority of nonusers are Hispanic (67.3%), Non-Hispanic Black (66.4%) and patients who are above 65 years old (63.6%). The oldest population (above 65 years old) was less likely to use online medical records (OR >65=1.51, P < 0.001). Non-Hispanic White patients were more likely to use online medical records compared to the other two races (OR black=1.71; OR hispanic=1.65, P <0.001). Patients who were diagnosed with cancer were more likely to use online medical records compared to patients with no cancer (ORnocancer=1.31, P <0.01). Among nonusers, older patients (>=65 years old) preferred speaking directly to their healthcare providers (ORSpeakDirectly =1.76, P <0.001), were more concerned about privacy issues caused by online medical records (ORConcernedPrivacy =1.79, P <0.001), and felt uncomfortable using the systems (OR Uncomfortable =10.55, P <0.001) compared to age 18-34 years old. Black and Hispanic patients were more concerned about privacy issues (ORH-NHB =1.42, P < 0.01).

Conclusions:

Studies should consider social factors such as gender, race/ethnicity, and age when monitoring trends in eHealth use to ensure that eHealth use does not induce greater health status and health care disparities between people with different backgrounds and demographics.Online medical records, cancer, patient portals, communication.