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Online Medical Record Nonuse Among Patients: Data Analysis Study of the 2019 Health Information National Trends Survey
Journal of Medical Internet Research ( IF 7.4 ) Pub Date : 2021-02-22 , DOI: 10.2196/24767
Safa Elkefi , Zhongyuan Yu , Onur Asan

Background: Online medical records are being used to organize processes in clinical and outpatient settings and to forge doctor-patient communication techniques that build mutual understanding and trust. Objective: We aimed to understand the reasons why patients tend to avoid using online medical records and to compare the perceptions that patients have of online medical records based on demographics and cancer diagnosis. Methods: We used data from the Health Information National Trends Survey Cycle 3, a nationally representative survey, and assessed outcomes using descriptive statistics and chi-square tests. The patients (N=4328) included in the analysis had experienced an outpatient visit within the previous 12 months and had answered the online behavior question regarding their use of online medical records. Results: Patients who were nonusers of online medical records consisted of 58.36% of the sample (2526/4328). The highest nonuser rates were for patients who were Hispanic (460/683, 67.35%), patients who were non-Hispanic Black (434/653, 66.46%), and patients who were older than 65 years (968/1520, 63.6%). Patients older than 65 years were less likely to use online medical records (odds ratio [OR] 1.51, 95% CI 1.24-1.84, P<.001). Patients who were White were more likely to use online medical records than patients who were Black (OR 1.71, 95% CI 1.43-2.05, P<.001) or Hispanic (OR 1.65, 95% CI 1.37-1.98, P<.001). Patients who were diagnosed with cancer were more likely to use online medical records compared to patients with no cancer (OR 1.31, 95% CI 1.11-1.55, 95% CI 1.11-1.55, P=.001). Among nonusers, older patients (≥65 years old) preferred speaking directly to their health care providers (OR 1.76, 95% CI 1.35-2.31, P<.001), were more concerned about privacy issues caused by online medical records (OR 1.79, 95% CI 1.22-2.66, P<.001), and felt uncomfortable using the online medical record systems (OR 10.55, 95% CI 6.06-19.89, P<.001) compared to those aged 18-34 years. Patients who were Black or Hispanic were more concerned about privacy issues (OR 1.42, 1.09-1.84, P=.007). 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 demographic characteristics. Trial Registration:

This is the abstract only. Read the full article on the JMIR site. JMIR is the leading open access journal for eHealth and healthcare in the Internet age.


中文翻译:

患者不使用在线医疗记录:2019年健康信息国家趋势调查的数据分析研究

背景:在线医疗记录被用于组织临床和门诊环境中的流程,并建立可以增进相互理解和信任的医患沟通技术。目的:我们旨在了解患者倾向于避免使用在线医疗记录的原因,并根据人口统计学和癌症诊断比较患者对在线医疗记录的看法。方法:我们使用了来自国家代表调查“健康信息国家趋势调查第3周期”的数据,并使用描述性统计数据和卡方检验评估了结果。分析中包括的患者(N = 4328)在过去的12个月内经历了一次门诊就诊,并回答了有关使用在线病历的在线行为问题。结果:不使用在线医疗记录的患者占样本的58.36%(2526/4328)。非使用者使用率最高的是西班牙裔患者(460/683,67.35%),非西班牙裔黑人患者(434/653,66.46%)和65岁以上患者(968/1520,63.6%) )。65岁以上的患者不太可能使用在线医疗记录(赔率[OR] 1.51,95%CI 1.24-1.84,P <.001)。与黑人(OR 1.71,95%CI 1.43-2.05,P <.001)或西班牙裔(OR 1.65,95%CI 1.37-1.98,P <.001)的患者相比,白人患者更可能使用在线医疗记录)。与没有癌症的患者相比,被诊断出患有癌症的患者更有可能使用在线医疗记录(OR 1.31,95%CI 1.11-1.55,95%CI 1.11-1.55,P = .001)。在非用户中,年龄较大的患者(≥65岁)更喜欢直接与他们的医疗服务提供者交谈(OR 1.76,95%CI 1.35-2.31,P <.001),他们更担心由在线医疗记录引起的隐私问题(OR 1.79,95% CI 1.22-2.66,P <.001),与18-34岁年龄组相比,使用在线病历系统(OR 10.55,95%CI 6.06-19.89,P <.001)感到不舒服。黑人或西班牙裔患者更关心隐私问题(OR 1.42,1.09-1.84,P = .007)。结论:在监测电子卫生保健使用趋势时,研究应考虑社会因素,例如性别,种族/族裔和年龄,以确保电子卫生保健使用不会引起不同背景和人口特征的人们之间更大的健康状况和医疗保健差异。试用注册:76,95%CI 1.35-2.31,P <.001),更关注由在线医疗记录引起的隐私问题(OR 1.79,95%CI 1.22-2.66,P <.001),使用在线医疗后感到不舒服记录系统(OR 10.55,95%CI 6.06-19.89,P <.001),年龄在18-34岁之间。黑人或西班牙裔患者更关心隐私问题(OR 1.42,1.09-1.84,P = .007)。结论:在监测电子卫生保健使用趋势时,研究应考虑社会因素,例如性别,种族/族裔和年龄,以确保电子卫生保健使用不会引起不同背景和人口特征的人们之间更大的健康状况和医疗保健差异。试用注册:76,95%CI 1.35-2.31,P <.001),更关注由在线医疗记录引起的隐私问题(OR 1.79,95%CI 1.22-2.66,P <.001),使用在线医疗后感到不舒服记录系统(OR 10.55,95%CI 6.06-19.89,P <.001),年龄在18-34岁之间。黑人或西班牙裔患者更关心隐私问题(OR 1.42,1.09-1.84,P = .007)。结论:在监测电子卫生保健使用趋势时,研究应考虑社会因素,例如性别,种族/族裔和年龄,以确保电子卫生保健使用不会引起不同背景和人口特征的人们之间更大的健康状况和医疗保健差异。试用注册:与18-34岁的人相比,使用在线病历系统(OR 10.55,95%CI 6.06-19.89,P <.001)感到不舒服。黑人或西班牙裔患者更关心隐私问题(OR 1.42,1.09-1.84,P = .007)。结论:在监测电子卫生保健使用趋势时,研究应考虑社会因素,例如性别,种族/族裔和年龄,以确保电子卫生保健使用不会引起不同背景和人口特征的人们之间更大的健康状况和医疗保健差异。试用注册:与18-34岁的人相比,使用在线病历系统(OR 10.55,95%CI 6.06-19.89,P <.001)感到不舒服。黑人或西班牙裔患者更关心隐私问题(OR 1.42,1.09-1.84,P = .007)。结论:在监测电子卫生保健使用趋势时,研究应考虑社会因素,例如性别,种族/族裔和年龄,以确保电子卫生保健使用不会引起不同背景和人口特征的人们之间更大的健康状况和医疗保健差异。试用注册:研究应在监测电子卫生保健使用趋势时考虑诸如性别,种族/民族和年龄等社会因素,以确保电子卫生保健使用不会引起不同背景和人口特征的人们之间更大的健康状况和医疗保健差异。试用注册:研究应在监测电子卫生保健使用趋势时考虑诸如性别,种族/民族和年龄等社会因素,以确保电子卫生保健使用不会引起不同背景和人口特征的人们之间更大的健康状况和医疗保健差异。试用注册:

这仅仅是抽象的。阅读JMIR网站上的全文。JMIR是互联网时代电子健康和医疗保健领域领先的开放获取期刊。
更新日期:2021-02-22
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