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Research ArticleOriginal Research

Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey

Katrina J. Serrano, Mandi Yu, William T. Riley, Vaishali Patel, Penelope Hughes, Kathryn Marchesini and Audie A. Atienza
The Annals of Family Medicine January 2016, 14 (1) 34-40; DOI: https://doi.org/10.1370/afm.1888
Katrina J. Serrano
1National Cancer Institute, National Institutes of Health, Rockville, MD
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  • For correspondence: katrina.serrano@nih.gov
Mandi Yu
1National Cancer Institute, National Institutes of Health, Rockville, MD
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William T. Riley
1National Cancer Institute, National Institutes of Health, Rockville, MD
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Vaishali Patel
2Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, Washington, DC
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Penelope Hughes
2Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, Washington, DC
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Kathryn Marchesini
2Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, Washington, DC
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Audie A. Atienza
1National Cancer Institute, National Institutes of Health, Rockville, MD
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    Table 1

    Characteristics of Respondents (N = 3,165)

    CharacteristicRespondents
    No.Weighted % (95% CI)
    Sex
     Male1,24148.7 (46.8–50.6)
     Female1,92451.3 (49.4–53.2)
    Age-group, y
     18–3443526.8 (25.3–28.3)
     35–4972730.3 (28.7–31.9)
     50–641,10225.3 (24.7–25.9)
     ≥6590117.5 (17.0–18.0)
    Race/ethnicity
     Hispanic58415.4 (14.4–16.3)
     Non-Hispanic black50110.9 (9.8–12.0)
     Non-Hispanic othera2437.2 (6.7–7.6)
     Non-Hispanic white1,83666.6 (65.0–68.1)
    Education level
     Less than high school3039.7 (8.5–10.9)
     High school graduate71524.5 (22.6–26.5)
     Some college95332.6 (30.8–34.3)
     College graduate or more1,19433.2 (32.7–33.6)
    Income group
     <$20,00079621.0 (19.0–23.0)
     $20,000 to <$35,00047014.3 (12.3–16.3)
     $35,000 to <$50,00046014.7 (12.3–17.1)
     $50,000 to <$75,00052317.8 (15.7–20.0)
     ≥$75,00091632.2 (29.8–34.5)
    Professional trust information
     Low/no trust35216.7 (16.3–17.1)
     High trust2,81383.3 (82.9–83.7)
    Professional trust care
     Low/no reliance98831.3 (28.7–33.9)
     High reliance2,17768.7 (66.1–71.3)
    Used text messaging for health information exchange in past year
     No39514.0 (11.5–16.4)
     Yes2,77086.0 (83.6–88.5)
    Used mobile application for health information exchange in past year
     No2,97493.6 (92.1–95.1)
     Yes1916.4 (4.9–7.9)
    • ↵a Aggregated because of small sample sizes in the Asian, Native Hawaiian/Pacific Islander, American Indian, and multiple races categories.

    • View popup
    Table 2

    Frequency of Willingness to Exchange Health Information via Mobile Device According to Health Information Type

    Type of Health InformationWillingness to Exchange, Weighted % (95% CI)
    Not at AllA LittleSomewhatVery
    Appointment reminders15.1 (13.3–16.9)8.6 (6.8–10.3)19.2 (16.7–21.7)57.2 (54.1–60.2)
    General health tips26.5 (24.2–28.8)17.7 (15.3–20.2)25.1 (22.8–27.4)30.6 (28.0–33.3)
    Medication reminders24.2 (22.1–26.3)14.6 (12.1–17.1)23.6 (20.8–26.5)37.6 (34.3–40.8)
    Laboratory/test results33.4 (30.0–36.8)12.2 (10.0–14.4)20.9 (18.8–23.1)33.5 (30.7–36.3)
    Diagnostic information43.6 (40.3–46.9)12.1 (10.0–14.2)19.5 (17.0–22.1)24.8 (22.3–27.3)
    Vital signsa33.0 (29.8–36.1)13.2 (11.4–15.0)23.3 (20.3–26.2)30.6 (27.0–34.1)
    Lifestyle behaviors31.5 (28.8–34.2)20.2 (17.9–22.4)23.3 (20.7–25.8)25.1 (22.4–27.8)
    Symptoms30.8 (28.1–33.5)16.4 (13.9–18.8)24.5 (22.1–26.9)28.4 (25.4–31.3)
    Digital images/video39.8 (37.0–42.6)16.8 (14.6–19.1)19.4 (16.9–21.8)24.0 (20.8–27.2)
    • ↵a Heart rate, blood pressure, glucose levels, etcetera.

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    Table 3

    Odds of Willingness to Exchange Health Information via Mobile Device According to Health Information Type

    Type of Health InformationWillingness to Exchange, Odds Ratio (95% CI)a
    A LittleSomewhatVery
    Diagnostic information (ref)1.001.001.00
    Appointment reminders2.05 (1.52–2.78)2.83 (2.28–3.52)6.66 (5.68–7.81)
    General health tips2.42 (1.87–3.14)2.11 (1.70–2.63)2.03 (1.74–2.38)
    Medication reminders2.18 (1.64–2.91)2.18 (1.79–2.65)2.73 (2.35–3.19)
    Laboratory/test results1.32 (1.06–1.64)1.40 (1.23–1.58)1.76 (1.62–1.92)
    Vital signs1.45 (1.17–1.80)1.58 (1.37–1.81)1.63 (1.48–1.80)
    Lifestyle behaviors2.31 (1.92–2.79)1.65 (1.37–1.98)1.40 (1.24–1.58)
    Symptoms1.92 (1.53–2.40)1.77 (1.55–2.03)1.62 (1.46–1.79)
    Digital images/video1.53 (1.20–1.93)1.09 (0.90–1.31)1.06 (0.96–1.18)
    • ref = reference group.

    • ↵a Reference group was “not at all” willing.

    • View popup
    Table 4

    Odds of Willingness to Exchange Different Types of Health Information via Mobile Devices According to Respondent Characteristics

    VariableWillingness to Exchange, Odds Ratio (95% CI)
    Appointment RemindersGeneral Health TipsMedication RemindersLaboratory/Test ResultsDiagnostic InformationVital SignsLifestyle BehaviorsSymptomsDigital Images/Video
    Sex
     Male (ref)1.001.001.001.001.001.001.001.001.00
     Female1.02 (0.79–1.32)0.98 (0.78–1.24)0.87 (0.71–1.08)0.98 (0.79–1.22)0.84 (0.68–1.04)0.93 (0.75–1.15)0.90 (0.71–1.14)0.92 (0.72–1.17)0.91 (0.73–1.12)
    Age-group, y
     18–34 (ref)1.001.001.001.001.001.001.001.001.00
     35–490.84 (0.56–1.27)0.88 (0.66–1.16)0.84 (0.63–1.13)0.82 (0.61–1.09)0.81 (0.61–1.09)0.79 (0.60–1.04)0.82 (0.60–1.12)0.83 (0.63–1.08)0.79 (0.59–1.04)
     50–640.44a 0.30–0.63)0.51a (0.39–0.67)0.55a (0.42–0.72)0.63a (0.44–0.91)0.64a (0.46–0.90)0.52a (0.38–0.73)0.49a (0.36–0.65)0.51a (0.39–0.66)0.42a (0.31–0.57)
     ≥650.23a 0.15–0.36)0.29a (0.22–0.40)0.35a (0.25–0.48)0.54a (0.38–0.78)0.54a (0.38–0.78)0.41a (0.29–0.59)0.35a (0.26–0.47)0.34a (0.25–0.47)0.29a (0.20–0.40)
    Race/ethnicity
     Hispanic1.05 (0.72–1.54)1.33 (0.94–1.87)1.60a (1.09–2.35)1.38 (0.98–1.94)1.33 (0.95–1.87)1.19 (0.91–1.55)1.33 (0.95–1.86)1.34 (0.98–1.83)1.17 (0.86–1.59)
     Non-Hispanic black0.85 (0.54–1.34)1.14 (0.79–1.66)1.37 (0.89–2.10)0.81 (0.60–1.10)0.79 (0.58–1.07)0.93 (0.66–1.29)1.12 (0.76–1.65)1.07 (0.72–1.59)1.02 (0.73–1.44)
     Non-Hispanic other0.68 (0.40–1.17)0.92 (0.57–1.49)0.92 (0.57–1.50)1.02 (0.60–1.71)1.01 (0.57–1.78)0.95 (0.57–1.56)1.11 (0.66–1.87)0.83 (0.46–1.49)0.91 (0.54–1.55)
     Non-Hispanic white (ref)1.001.001.001.001.001.001.001.001.00
    Education level
     Less than high school0.46a (0.31–0.67)0.48a (0.31–0.75)0.52a 0.35–0.77)0.75 (0.50–1.13)0.70 (0.46–1.07)0.62a (0.42–0.92)0.41a (0.26–0.64)0.57a (0.38–0.84)0.49a (0.31–0.78)
     High school graduate0.37a 0.26–0.52)0.53a (0.38–0.74)0.55a 0.40–0.76)0.61a (0.46–0.81)0.66a (0.50–0.88)0.61a (0.46–0.81)0.42a (0.30–0.59)0.53a (0.39–0.72)0.55a (0.39–0.78)
     Some college0.64a 0.46–0.88)0.88 (0.66–1.18)0.83 (0.63–1.10)0.81 (0.64–1.03)0.78 (0.61–1.01)0.79 (0.61–1.04)0.70a (0.54–0.92)0.83 (0.64–1.09)0.78 (0.60–1.02)
     College graduate or more (ref)1.001.001.001.001.001.001.001.001.00
    Income group
     <$20,0000.64 (0.37–1.09)0.64a (0.42–0.97)0.73 (0.50–1.07)0.66a (0.47–0.92)0.92 (0.67–1.25)0.72 (0.51–1.03)0.70 (0.47–1.06)0.73 (0.49–1.11)0.63a (0.44–0.90)
     $20,000 to <$35,0000.68 (0.45–1.03)0.70 (0.45–1.10)0.60a (0.41–0.89)0.92 (0.62–1.38)1.04 (0.72–1.50)0.76 (0.53–1.08)0.88 (0.58–1.33)0.90 (0.60–1.36)0.77 (0.49–1.21)
     $35,000 to <$50,0000.88 (0.53–1.47)0.74 (0.48–1.15)0.74 (0.53–1.04)0.83 (0.60–1.15)1.00 (0.71–1.41)0.85 (0.59–1.22)0.79 (0.55–1.15)0.94 (0.61–1.46)0.87 (0.59–1.28)
     $50,000 to <$75,0000.79 (0.51–1.21)0.78 (0.56–1.09)0.73a (0.54–0.99)0.67a (0.50–0.88)0.76 (0.56–1.01)0.68a (0.51–0.90)0.75 (0.54–1.03)0.74 (0.55–1.00)0.69a (0.51–0.95)
     ≥$75,000 (ref)1.001.001.001.001.001.001.001.001.00
    Trust in health care professional
     Professional trust information1.73a 1.31–2.27)1.71a (1.42–2.06)1.67a (1.35–2.06)1.53a (1.18–2.00)1.33a (1.00–1.76)1.43a (1.13–1.80)1.37a (1.09–1.71)1.42a (1.16–1.73)1.19 (0.93–1.53)
     Professional trust care0.89 (0.59–1.35)0.87 (0.63–1.20)0.81 (0.59–1.10)0.83 (0.57–1.21)0.76 (0.52–1.11)0.87 (0.62–1.23)0.99 (0.71–1.39)0.90 (0.65–1.25)0.80 (0.58–1.11)
    Use of HIE in past year
     Used text messaging for HIE1.46 (0.87–2.44)1.27 (0.83–1.93)1.16 (0.74–1.84)1.24 (0.76–2.01)1.09 (0.67–1.76)1.27 (0.71–2.24)1.34 (0.85–2.14)1.45 (0.96–2.19)1.59a (1.04–2.42)
     Used mobile app for HIE1.41 (0.62–3.22)2.64a (1.22–5.71)2.29a (1.17–4.48)2.27a (1.14–4.52)1.98 (0.98–3.99)2.24a (1.13–4.46)1.62 (0.75–3.46)2.04a (1.02–4.07)1.62 (0.81–3.23)
    • app= application; HIE = health information exchange; ref = reference group.

    • ↵a Statistically significant.

    • Note: Odds ratios (95% CIs) from proportional odds models. Odds ratios are for being in the “very willing” category vs lower willingness categories.

Additional Files

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  • The Article in Brief

    Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey

    Katrina J. Serrano , and colleagues

    Background The growth of mobile devices offers new opportunities for patients and health care professionals to share health information electronically. This study looks at patients' willingness to electronically exchange different types of health information.

    What This Study Found Patients are less willing to use mobile devices to exchange information that may be considered sensitive or complex. However, they are very willing to exchange appointment reminders, general health tips, medication reminders, laboratory test results, vital signs, lifestyle behaviors and symptoms. Regardless of the information type, older adults (aged 50 or older) have lower odds of being willing to exchange any type of information compared to younger adults (aged 18 to 34).

    Implications

    • The authors conclude that information type and demographic group should be considered when developing and tailoring mobile technologies for patient-provider communication.
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Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey
Katrina J. Serrano, Mandi Yu, William T. Riley, Vaishali Patel, Penelope Hughes, Kathryn Marchesini, Audie A. Atienza
The Annals of Family Medicine Jan 2016, 14 (1) 34-40; DOI: 10.1370/afm.1888

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Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey
Katrina J. Serrano, Mandi Yu, William T. Riley, Vaishali Patel, Penelope Hughes, Kathryn Marchesini, Audie A. Atienza
The Annals of Family Medicine Jan 2016, 14 (1) 34-40; DOI: 10.1370/afm.1888
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