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Is there a digital divide among physicians? A geographic analysis of information technology in Southern California physician offices.

ABSTRACT: The aim of this study was to determine whether physician offices located in high-minority and low-income neighborhoods have different levels of access to information technology than offices located in lower-minority and higher-income areas.A cross-sectional survey was conducted of pediatrics, family medicine, and general practice offices in Orange County, California. Survey data were linked with community demographic data from the 2000 Census using a geographical information system.Of 307 offices surveyed, 141 responded (46%). Offices located in high-minority and high-poverty areas were as likely to respond as other offices. Among responding offices, 94% had a computer, 77% had Web access, 29% had broadband Internet access, and 53% used computerized scheduling and billing systems. Offices located in minority and low-income communities had equivalent access to each technology. Offices in communities with larger proportions of Hispanics were less likely to have practice Web pages, but other uses of the Internet were not associated with practice location. Offices reported high levels of interest in online clinical systems but also high levels of concern about these systems' usability and confidentiality. Offices with Web access and those with practice management systems expressed greater interest in online clinical systems but also greater levels of concern about usability and confidentiality. These attitudes were equivalent among offices in different communities.Primary care offices located in poor and minority communities in a large, suburban county had high levels of access to and interest in Web-based systems. Physicians' offices may therefore provide a venue for online services aimed at improving health outcomes for poor and minority communities. Research is needed in other geographic regions to determine the generalizability of these findings.

SUBMITTER: Bell DS

PROVIDER: S-EPMC212786 | biostudies-literature | 2003 Sep-Oct

REPOSITORIES: biostudies-literature

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Is there a digital divide among physicians? A geographic analysis of information technology in Southern California physician offices.

Bell Douglas S DS Daly Dianna M DM Robinson Paul P

Journal of the American Medical Informatics Association : JAMIA 20030604 5

<h4>Objective</h4>The aim of this study was to determine whether physician offices located in high-minority and low-income neighborhoods have different levels of access to information technology than offices located in lower-minority and higher-income areas.<h4>Design</h4>A cross-sectional survey was conducted of pediatrics, family medicine, and general practice offices in Orange County, California. Survey data were linked with community demographic data from the 2000 Census using a geographical ...[more]

PMID: 12807804

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Project description:ImportanceEnabling widespread interoperability-the ability of health information technology systems to exchange information and to use that information without special effort-is a primary focus of public policy on health information technology. More information on clinicians' experience using that technology can serve as one measure of the impact of that policy.ObjectiveTo assess primary care physician perspectives on the state of interoperability.Design, setting, and participantsA cross-sectional survey of family medicine physicians in the US was conducted from December 12, 2021, to October 12, 2022. A sample of family medicine physicians who completed the Continuous Certification Questionnaire (CCQ), a required part of the American Board of Family Medicine certification process, which has a 100% response rate, were invited to participate.Main outcomes and measuresEighteen items on the CCQ assessed experience accessing and using various information from outside organizations, including medications, immunizations, and allergies.ResultsA total of 2088 physicians (1053 women [50%]; age reported categorically as either ≥50 years or <50 years) completed the CCQ interoperability questions in 2022. Of these respondents, 35% practiced in hospital or health system-owned practices, while 27% practiced in independently owned practices. Eleven percent were very satisfied with their ability to electronically access all 10 types of information from outside organizations included on the questionnaire, and a mean of 70% were at least somewhat satisfied. A total of 23% of family medicine physicians reported information from outside organizations was very easy to use, and an additional 65% reported that information was somewhat easy to use. Only 8% reported that information from different electronic health record (EHR) developers' products was very easy to use compared with 38% who reported information from the same EHR developer's product was very easy to use.Conclusions and relevanceThis survey study of family medicine physicians found modest and uneven improvement in physicians' experience with interoperability. These findings suggest that substantial heterogeneity in satisfaction by information type, source of information, EHR, practice type, ownership, and patient population necessitates diverse policy and strategies to improve interoperability.

Project description:BackgroundThe digital divide refers to technological disparities based on demographic characteristics (eg, race and ethnicity). Lack of physical access to the internet inhibits online health information seeking (OHIS) and exacerbates health disparities. Research on the digital divide examines where and how people access the internet, whereas research on OHIS investigates how intersectional identities influence OHIS. We combine these perspectives to explicate how unique context-device access pairings operate differently across intersectional identities-particularly racial and ethnic groups-in the domain of OHIS.ObjectiveThis study aims to examine how different types of internet access relate to OHIS for different racial and ethnic groups. We investigate relationships among predisposing characteristics (ie, age, sex, education, and income), internet access (home computer, public computer, work computer, and mobile), health needs, and OHIS.MethodsAnalysis was conducted using data from the 2019 Health Information National Trends Survey. Our theoretical model of OHIS explicates the roles of internet access and health needs for racial and ethnic minority groups' OHIS. Participant responses were analyzed using structural equation modeling. Three separate group structural equation modeling models were specified based on Black, Latine, and White self-categorizations.ResultsOverall, predisposing characteristics (ie, age, sex, education, and income) were associated with internet access, health needs, and OHIS; internet access was associated with OHIS; and health needs were associated with OHIS. Home computer and mobile access were most consistently associated with OHIS. Several notable linkages between predisposing characteristics and internet access differed for Black and Latine individuals. Older racial and ethnic minorities tended to access the internet on home and public computers less frequently; home computer access was a stronger predictor of OHIS for White individuals, and mobile access was a stronger predictor of OHIS for non-White individuals.ConclusionsOur findings necessitate a deeper unpacking of how physical internet access, the foundational and multifaceted level of the digital divide, affects specific racial and ethnic groups and their OHIS. We not only find support for prior work on the digital divide but also surface new insights, including distinct impacts of context-device access pairings for OHIS and several relationships that differ between racial and ethnic groups. As such, we propose interventions with an intersectional approach to access to ameliorate the impact of the digital divide.

Project description:BackgroundWomen are key players in agriculture, but they are under-resourced, particularly in terms of finance. Microfinance has long been recognized as the most effective method of financially empowering these women, but using the benefits of digital technology can help scale it up and ensure its long-term viability.MethodsThe study area was Southern Nigeria. Respondents were women agripreneurs (n=479), from six states. 239 women agripreneurs who accessed digital financial products and 240 women agripreneurs who did not access financial products participated in the survey in 2019.ResultsThe tests for significant difference between income of participants and non-participants in digital finance indicated a T-value of 3.214 (P< 0.001), which implies that there was a significant difference in the income of those that are accessing digital financial products (DFPs) and those that are not accessing DFPs. The tests for significant difference between savings of participants and non-participants indicated a T-value of 2.479 (p<0.05), which also implies that there was a significant difference in the women agripreneurs' savings for participants and non-participants in DFPs. Only 2.5% of women agripreneurs are participating in micro-insurance in Southern Nigeria.ConclusionsWomen agripreneurs who are accessing digital financial products earned more income and saved more than those who are not accessing digital financial products. This implies that you are more advantaged in using digital finance in business. Micro-insurance is poorly accessed in Nigeria, and awareness of insurance products is moderately low. This study recommends that Central Bank of Nigeria should engage in more outreach programmes to enable all women in Nigeria access digital financial products because of its convenience and contributions to success in business. Insurance companies should capitalize on business models that incorporate mobile technologies in order to increase insurance penetration in rural areas.

Dataset Information

Is there a digital divide among physicians? A geographic analysis of information technology in Southern California physician offices.

Publications

Is there a digital divide among physicians? A geographic analysis of information technology in Southern California physician offices.

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