Patient Race/Ethnicity and Shared Medical Record Use Among Diabetes Patients

Bibliographic Data

ID9103857
AuthorsCourtney R Lyles (0000-0002-1111-8595, University of California San Francisco Medical Center, corresponding author), Lynne T Harris (University of Washington), Luesa Jordan (Kaiser Permanente Washington Health Research Institute), Lou Grothaus (Kaiser Permanente Washington Health Research Institute), Linda Wehnes (Kaiser Permanente Washington Health Research Institute), Robert J Reid (0000-0002-9008-6375, Kaiser Permanente Washington Health Research Institute), James D Ralston (0000-0001-6317-7987, University of Washington)
Year2012
Volume50
Issue5
Pages434-440
Publication date2012-05-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e318249d81b
PMID22354209
OpenAlexW2316792303
LanguageEN
Citations received4
References cited20

BACKGROUND: Previous studies have documented racial/ethnic differences in patients' use of websites providing shared electronic medical records between patients and health care professionals. Less is known about whether these are driven by patient-level preferences and/or barriers versus broader provider or system factors. METHODS: Cross-sectional study of diabetes patients in an integrated delivery system in 2008-2009. Primary measures were race/ethnicity and shared medical record (SMR) use. Covariates included sociodemographics (age, sex, income, education), health status (comorbidity, diabetes severity), and provider characteristics (encouragement of SMR, secure messaging use, clinic). RESULTS: The majority (62%) of Whites used the SMR, compared with 34% of Blacks, 37% of Asians, and 55% of other race/ethnicity (P<0.001). Most respondents (76%) stated that their provider had encouraged them to use the SMR, with no differences by race/ethnicity. Patients saw primary care providers who used a similar amount of secure messaging in their practices-except Asians, who were less likely to see high-messaging providers. In fully adjusted models, Blacks [odds ratio (OR), 0.18; 95% confidence interval (CI), 0.11-0.30] and Asians (OR, 0.40; 95% CI, 0.20-0.77) were significantly less likely than Whites to use the SMR. When restricted to individuals reporting at least occasional Internet use, this finding remained for Black respondents (OR, 0.25; 95% CI, 0.10-0.63). CONCLUSIONS: Among diabetes patients, differences in SMR use by race/ethnicity were not fully explained by differences in age, sex, sociodemographics, health status, or provider factors-particularly for Black patients. There were few racial/ethnic differences in provider encouragement or provider secure messaging use that would have suggested disparities at the provider level

Comorbidity · Confidence interval · Cross-sectional study · Diabetes mellitus · Ethnic group · Family medicine · Health care · Logistic regression · Medical record · Odds · Odds ratio · Psychiatry · Race (biology) · Young adult · Demography · Electronic Health Records Systems · Healthcare Systems and Technology · Internal Medicine · Medicine · Telemedicine and Telehealth Implementation · Gerontology

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