Introduction

1. Should We Change The Way We Communicate? A Study On The Availability Of Electronic Communication In Primary Care Patients Anna Haring, Tamara Armstrong Psy.D., Sandra Burge Ph.D. The University of Texas Health Science Center at San Antonio Introduction Results Primary care physicians are seeking new methods of communicating with patients in order to improve the quality and efficiency of health care delivery. Electronic devices such as cell phones and computers can be used to efficiently schedule appointments and send test results. Studies have shown that text messaging significantly decreases patient non-attendance and is more cost effective than mobile phone reminders (1). Electronic devices can also be useful in implementing the chronic care model (2), shown to be effective in improving clinical, behavioral, psychosocial, and diabetes knowledge outcomes for people with diabetes (2). Electronic devices allow practices to be more proactive with their patients following up on lab results, keeping patient registries, and appointment reminders. However, little is known about cell phone and computer availability among primary care patients, especially among patients of limited financial resources. Therefore, this study focuses on discovering the availability of electronic communication in primary care patients, and the correlation with patient characteristics, such as socioeconomic status, race, and age. 557 people completed the survey 4.0% of people did not have a phone 84.4% of people had a cell phone 58.1% of people used texting 62.8% of people had a computer 65.2% Female 56.9% Hispanic, 27.6% Caucasian, 13.3% African American, 2.2% Asian 20.7% Private insurance, 49.7% Government insurance, 29.6% Self pay/county plan Mean age was 45.8 years old Most patients (84%)in this study had cell phones. We observed that older patients and African American patients were least likely subgroups to have cell phones. (Figure 1) Most patients (65%) had a computer at home. We observed that Caucasians, patients with private insurance, and young people were most likely to have computers. (Figure 2) In every subgroup, the most preferred electronic method to receive health information was e-mail, and the least preferred was the internet. Texting was very popular among the youngest age group (Figures 3, 4) Methods • Subjects Medical students documented 726 outpatient visits from 9 family medicine residency programs across Texas.  Eligible patients included all patient-visitors seeing a physician in the study clinics during the study period.. Patients’ ages ranged from infants to 97 years old.  • Measurement  A Patient Survey elicited information about patients’ use of telephones and computers.  Study materials were available in Spanish and English. • Procedure Over a one-month period, students identified half-days for data collection, then randomly selected a physician to shadow.  During the physician’s clinic session, the student invited all the physician’s patients to participate in the study.  After informed consent, patients completed the Patient Survey. Discussion This study showed that 96% of patients from our low-income communities had telephones, and 84.4% had cell phones. The type of phone varied significantly by age, ethnic group, and insurance status (a marker of socioeconomic conditions). As a comparison, A US survey from 2010 shows that 91% of Americans own a cell phone while 26.6% of people only use a cell phone and not a landline(3). According to the International Telecommunications Union, 64% of Americans use text messaging (4). 63% of our patients had a computer and 36.2% were interested in receiving health information by e-mail. But the internet was much less popular for this purpose. The strong preference for email is probably due to the ease of use and increased privacy often associated with emails. Physicians and healthcare personnel can use these findings to guide communication strategies with their patients. Due to the rising proportion of people in need of primary care, it is important for physicians to find more efficient ways to communicate with their patients. A greater dialogue between physician and patient will help decrease health care costs while increasing patient health and satisfaction. References • Leong KC, Chen WS, Leong KW, Mastura I, Mimi O, Sheikh MA, Zailinawati AH, Ng CJ, Phua KL and Teng CL. The use of text messaging to improve attendance in primary care: a randomised controlled trial. Family Practice 2006; 23: 699–705. • Piatt GA, Orchard TJ, Emerson S. Simmons D, Songer TJ, Brooks MM, Korytkowski M, and Siminerio LM. Translating the chronic care model into the community. Diabetes Care 2006; 29:811-817. • CTIA- The Wireless Association. Annualized wireless industry survey results 1985-2005. http://files.ctia.org/pdf/CTIA_Survey_Year_End_2010_Graphics.pdf • International Telecommunications Union. Mobile media usage in the past 30 days 2010. http://www.itu.int/ITU-D/ict/newslog/China+Trumps+US+In+Mobile+Internet+App+Use.aspx Acknowledgments This study was conducted in The Residency Research Network of Texas (RRNeT) with support from the Office of the Medical Dean at UTHSCSA and the Health Resources and Services Administration (Award # D54HP16444).