Provider interacting eHealth behaviors: trends, predictors, and differences by subpopulations (Preprint)

BACKGROUND Patient-centered communication (PCC) and provider interacting eHealth behaviors (PIEB) play important roles in healthcare quality and patient-centered care. PIEB are the provider-facing eHealth behaviors that communicate with healthcare providers or the healthcare system, for example, communicating via email with a doctor, looking up test results, and making appointments online. OBJECTIVE The purpose of this study was to comprehensively examine PIEB and its association with PCC. We hypothesized that PIEB increased from 2017 to 2020, patients with higher levels of PCC were more likely to engage in total, direct, and indirect PIEB, and that there are differences in PIEB by subpopulation when controlling for PCC. METHODS We used nationally representative survey data from the 2017, 2019, and 2020 Health Information National Trends Study (HINTS). We conducted trend and multivariate regression analyses to understand changes in the relationships between PCC and PIEB, as well as to identify any differences in PIEB among key sociodemographic groups. RESULTS PIEB increased in recent years, with the largest increases reported by participants who used email or the internet to communicate with a doctor or a doctor’s office from 38.56% to 53.44%. In 2020, participants who experienced more PCC had two times higher odds of engaging in PIEB (aOR=1.97, 95% CI 1.35-2.87). Adults who were older, had lower income, had less education, or lived in rural areas had significantly lower odds of PIEB. CONCLUSIONS The positive relationship between PCC and PIEB further illustrates the important role of online digital communication in delivering patient-centered care and enhancing health outcomes. Since differences among subpopulations remained in PIEB, we advocate for additional structural and educational interventions to expand access to broadband and eHealth tools for these groups. This research helps inform future progress in improving quality of care and the integration of health information technology into healthcare. It also highlights the importance of continued engagement and education to provide patients with the skills and resources to actively engage in directing their medical care.