Rural and Urban Differences in the Adoption of New Health Information and Medical Technologies

David Haggstrom, Joy Lee, Stephanie L. Dickinson, Sina Kianersi, Jamie L. Roberts, Evgenia Teal, Layla B. Baker, Susan Rawl

Research output: Contribution to journalArticle

Abstract

Background: This statewide survey sought to understand the adoption level of new health information and medical technologies, and whether these patterns differed between urban and rural populations. Methods: A random sample of 7,979 people aged 18-75 years, stratified by rural status and race, who lived in 1 of 34 Indiana counties with high cancer mortality rates and were seen at least once in the past year in a statewide health system were surveyed. Results: Completed surveys were returned by 970 participants. Rural patients were less likely than urban to use electronic health record messaging systems (28.3% vs 34.5%, P =.045) or any communication technology (43.0% vs 50.8%, P =.017). Rural patients were less likely to look for personal health information for someone else's medical record (11.0% vs 16.3%, P =.022), look-up test results (29.5% vs 38.3%, P =.005), or use any form of electronic medical record (EMR) access (57.5% vs 67.1%, P =.003). Rural differences in any use of communication technology or EMRs were no longer significant in adjusted models, while education and income were significantly associated. There was a trend in the higher use of low-dose computed tomography (CT) scan among rural patients (19.1% vs 14.4%, P =.057). No significant difference was present between rural and urban patients in the use of the human papilloma virus test (27.1% vs 26.6%, P =.880). Conclusions: Differences in health information technology use between rural and urban populations may be moderated by social determinants. Lower adoption of new health information technologies (HITs) than medical technologies among rural, compared to urban, individuals may be due to lower levels of evidence supporting HITs.

Original languageEnglish (US)
JournalJournal of Rural Health
DOIs
StatePublished - Jan 1 2019

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Medical Informatics
Urban Population
Electronic Health Records
Rural Population
Technology
Papillomaviridae
Communication
Personal Health Records
Health Status
Medical Records
Tomography
Education
Mortality
Health
Neoplasms
Surveys and Questionnaires

Keywords

  • cancer health services research
  • health behaviors
  • health care disparities
  • medical informatics
  • rural health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Rural and Urban Differences in the Adoption of New Health Information and Medical Technologies. / Haggstrom, David; Lee, Joy; L. Dickinson, Stephanie; Kianersi, Sina; Roberts, Jamie L.; Teal, Evgenia; Baker, Layla B.; Rawl, Susan.

In: Journal of Rural Health, 01.01.2019.

Research output: Contribution to journalArticle

Haggstrom, David ; Lee, Joy ; L. Dickinson, Stephanie ; Kianersi, Sina ; Roberts, Jamie L. ; Teal, Evgenia ; Baker, Layla B. ; Rawl, Susan. / Rural and Urban Differences in the Adoption of New Health Information and Medical Technologies. In: Journal of Rural Health. 2019.
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abstract = "Background: This statewide survey sought to understand the adoption level of new health information and medical technologies, and whether these patterns differed between urban and rural populations. Methods: A random sample of 7,979 people aged 18-75 years, stratified by rural status and race, who lived in 1 of 34 Indiana counties with high cancer mortality rates and were seen at least once in the past year in a statewide health system were surveyed. Results: Completed surveys were returned by 970 participants. Rural patients were less likely than urban to use electronic health record messaging systems (28.3{\%} vs 34.5{\%}, P =.045) or any communication technology (43.0{\%} vs 50.8{\%}, P =.017). Rural patients were less likely to look for personal health information for someone else's medical record (11.0{\%} vs 16.3{\%}, P =.022), look-up test results (29.5{\%} vs 38.3{\%}, P =.005), or use any form of electronic medical record (EMR) access (57.5{\%} vs 67.1{\%}, P =.003). Rural differences in any use of communication technology or EMRs were no longer significant in adjusted models, while education and income were significantly associated. There was a trend in the higher use of low-dose computed tomography (CT) scan among rural patients (19.1{\%} vs 14.4{\%}, P =.057). No significant difference was present between rural and urban patients in the use of the human papilloma virus test (27.1{\%} vs 26.6{\%}, P =.880). Conclusions: Differences in health information technology use between rural and urban populations may be moderated by social determinants. Lower adoption of new health information technologies (HITs) than medical technologies among rural, compared to urban, individuals may be due to lower levels of evidence supporting HITs.",
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