Patient characteristics associated with objective measures of digital health tool use in the United States: A literature review

The study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United States. We conducted a literature review of studies of patient-facing digital health tools that objectively evaluated use (eg, system/platform data representin...

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Published in:Journal of the American Medical Informatics Association : JAMIA Vol. 27; no. 5; p. 834
Main Authors: Nouri, Sarah S, Adler-Milstein, Julia, Thao, Crishyashi, Acharya, Prasad, Barr-Walker, Jill, Sarkar, Urmimala, Lyles, Courtney
Format: Journal Article
Language:English
Published: England 01.05.2020
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ISSN:1527-974X, 1527-974X
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Abstract The study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United States. We conducted a literature review of studies of patient-facing digital health tools that objectively evaluated use (eg, system/platform data representing frequency of use) by patient characteristics (eg, age, race or ethnicity, income, digital literacy). We included any type of patient-facing digital health tool except patient portals. We reran results using the subset of studies identified as having robust methodology to detect differences in patient characteristics. We included 29 studies; 13 had robust methodology. Most studies examined smartphone apps and text messaging programs for chronic disease management and evaluated only 1-3 patient characteristics, primarily age and gender. Overall, the majority of studies found no association between patient characteristics and use. Among the subset with robust methodology, white race and poor health status appeared to be associated with higher use. Given the substantial investment in digital health tools, it is surprising how little is known about the types of patients who use them. Strategies that engage diverse populations in digital health tool use appear to be needed. Few studies evaluate objective measures of digital health tool use by patient characteristics, and those that do include a narrow range of characteristics. Evidence suggests that resources and need drive use.
AbstractList The study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United States.OBJECTIVEThe study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United States.We conducted a literature review of studies of patient-facing digital health tools that objectively evaluated use (eg, system/platform data representing frequency of use) by patient characteristics (eg, age, race or ethnicity, income, digital literacy). We included any type of patient-facing digital health tool except patient portals. We reran results using the subset of studies identified as having robust methodology to detect differences in patient characteristics.MATERIALS AND METHODSWe conducted a literature review of studies of patient-facing digital health tools that objectively evaluated use (eg, system/platform data representing frequency of use) by patient characteristics (eg, age, race or ethnicity, income, digital literacy). We included any type of patient-facing digital health tool except patient portals. We reran results using the subset of studies identified as having robust methodology to detect differences in patient characteristics.We included 29 studies; 13 had robust methodology. Most studies examined smartphone apps and text messaging programs for chronic disease management and evaluated only 1-3 patient characteristics, primarily age and gender. Overall, the majority of studies found no association between patient characteristics and use. Among the subset with robust methodology, white race and poor health status appeared to be associated with higher use.RESULTSWe included 29 studies; 13 had robust methodology. Most studies examined smartphone apps and text messaging programs for chronic disease management and evaluated only 1-3 patient characteristics, primarily age and gender. Overall, the majority of studies found no association between patient characteristics and use. Among the subset with robust methodology, white race and poor health status appeared to be associated with higher use.Given the substantial investment in digital health tools, it is surprising how little is known about the types of patients who use them. Strategies that engage diverse populations in digital health tool use appear to be needed.DISCUSSIONGiven the substantial investment in digital health tools, it is surprising how little is known about the types of patients who use them. Strategies that engage diverse populations in digital health tool use appear to be needed.Few studies evaluate objective measures of digital health tool use by patient characteristics, and those that do include a narrow range of characteristics. Evidence suggests that resources and need drive use.CONCLUSIONFew studies evaluate objective measures of digital health tool use by patient characteristics, and those that do include a narrow range of characteristics. Evidence suggests that resources and need drive use.
The study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United States. We conducted a literature review of studies of patient-facing digital health tools that objectively evaluated use (eg, system/platform data representing frequency of use) by patient characteristics (eg, age, race or ethnicity, income, digital literacy). We included any type of patient-facing digital health tool except patient portals. We reran results using the subset of studies identified as having robust methodology to detect differences in patient characteristics. We included 29 studies; 13 had robust methodology. Most studies examined smartphone apps and text messaging programs for chronic disease management and evaluated only 1-3 patient characteristics, primarily age and gender. Overall, the majority of studies found no association between patient characteristics and use. Among the subset with robust methodology, white race and poor health status appeared to be associated with higher use. Given the substantial investment in digital health tools, it is surprising how little is known about the types of patients who use them. Strategies that engage diverse populations in digital health tool use appear to be needed. Few studies evaluate objective measures of digital health tool use by patient characteristics, and those that do include a narrow range of characteristics. Evidence suggests that resources and need drive use.
Author Adler-Milstein, Julia
Barr-Walker, Jill
Sarkar, Urmimala
Thao, Crishyashi
Lyles, Courtney
Nouri, Sarah S
Acharya, Prasad
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  surname: Lyles
  fullname: Lyles, Courtney
  organization: UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
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Copyright The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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Keywords health equity
social determinants of health
digital health
population health informatics
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Snippet The study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United States. We...
The study sought to determine which patient characteristics are associated with the use of patient-facing digital health tools in the United...
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SubjectTerms Consumer Health Informatics
Consumer Health Information
Female
Health Literacy
Health Status
Humans
Male
Mobile Applications
Race Factors
Self-Management
Text Messaging
United States
Title Patient characteristics associated with objective measures of digital health tool use in the United States: A literature review
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