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Trends and Predictors of Use of Digital Health Technology in the United States

  • Shiwani Mahajan
    Affiliations
    Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn

    Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn
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  • Yuan Lu
    Affiliations
    Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn

    Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn
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  • Erica S. Spatz
    Affiliations
    Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn

    Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn
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  • Khurram Nasir
    Affiliations
    Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Texas

    Center for Outcomes Research, Houston Methodist Research Institute, Texas
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  • Harlan M. Krumholz
    Correspondence
    Requests for reprints should be addressed to Harlan M. Krumholz, MD, SM, Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, 1 Church Street, Suite 200, New Haven, CT 06510.
    Affiliations
    Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn

    Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn

    Department of Health Policy and Management, Yale School of Public Health, New Haven, Conn
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      Abstract

      Background

      Digital health technology is becoming central to health care. A better understanding of the trends and predictors of its use could reflect how people engage with the health care system and manage their health care needs.

      Methods

      Using data from the National Health Interview Survey for years 2011 to 2018, we assessed the use of digital health technology among individuals aged ≥18 years in the United States across 2 domains: 1) search for health information online and 2) interaction with health care providers (eg, fill a prescription, schedule a medical appointment, or communicate with health care providers).

      Results

      Our study included 253,829 individuals; representing nearly 237 million adults in the United States annually; mean age 49.6 years (SD 18.4); 51.8% women; and 65.9% non-Hispanic white individuals. Overall, 49.2% of individuals reported searching for health information online and 18.5% reported at least 1 technology-based interaction with the health care system. Between 2011 and 2018, the proportion who searched for health information online increased from 46.5% to 55.3% (P < .001), whereas the proportion who used technology to interact with the health care system increased from 12.5% to 27.4% (P < .001). Although technology-based interaction with the health care system increased across most subgroups, there were significant disparities in the extent of increase across clinical and sociodemographic subgroups.

      Conclusions

      The use of digital health technologies increased between 2011 and 2018, however, the uptake of these technologies has been unequal across subgroups. Future innovations and strategies should focus on expanding the reach of digital heath technology across all subgroups of society to ensure that its expansion does not exacerbate the existing health inequalities.

      Keywords

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