- Healthcare providers looking to connect with minorities should develop an mHealth strategy that focuses on the smartphone.
That’s the takeaway from a pair of studies published this month in the American Journal of Managed Care. The studies – one focusing on the variation of devices used to access patient portals and the other examining mobile access to personal health records – found that black and Hispanic populations use smartphones far more often than non-Hispanic whites to access mHealth data, and in many cases that’s the only device they use.
The studies offer guidance on how to reach underserved populations, as well as offering a warning that mHealth programs now in place may be missing their target patients.
“Mobile devices are playing a large role in healthcare, from providing on-demand health information to helping patients and providers monitor and manage chronic conditions,” authors of the study on patient portal access pointed out. “However, researchers and healthcare organizations need to ensure that our increasing reliance on mobile technology does not exacerbate disparities in care and access among vulnerable populations.”
“Mobile devices present an opportunity for healthcare organizations to increase their patient engagement among black and Hispanic enrollees,” they added. “The accessibility and functionality of patient portals through mobile applications and mobile browsers may help reduce differences in patient portal use.”
Racial/Ethnic Variation in Devices Used to Access Patient Portals was conducted by Eva Chang, PhD, of RTI International, and researchers from the Kaiser Permanente Washington Health Research Institute, the UCSF Division of General Internal Medicine and Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and University Hospitals of Geneva. Bridging the Digital Divide: Mobile Access to Personal Health Records Among Patients With Diabetes was prepared by Ilana Graetz, PhD, of the University of Tennessee Health Science Center’s Department of Preventive Medicine, and researchers from Kaiser Permanente, UCSF, Massachusetts General Hospital’s Mongan Institute and Harvard Medical School’s Department of Health Care Policy.
Both studies, published in the January 2018 issue of AJMC, point out that access to healthcare resources is considerably lower among minorities, but those who are logging into patient portals or personal health records are doing so through mobile phones rather than PCs or tablets.
That’s a significant problem when a minority population is trying to use mHealth to manage a chronic condition like diabetes.
“The federal government has invested more than $30 billion to promote the widespread adoption of EHRs and tethered PHRs as a way to improve access and quality of care,” Graetz and her colleagues wrote. “However, these financial incentives do not require that PHRs be easily accessible via mobile devices. In fact, eligible providers caring for patients in regions with low broadband internet access are exempted from Meaningful Use objectives related to PHRs.”
“Although it is possible for patients with smartphones to access any available computer-based PHR using their mobile devices, websites that are not optimized for mobile use can be exceedingly difficult to navigate using the relatively small-sized smartphone screens,” they added. “To the extent that PHR use can improve chronic care management and clinical outcomes, limiting PHR access to patients with easy access to internet-connected computers could contribute to existing disparities in healthcare access and outcomes.”
That said, Graetz and her fellow researchers point out that mHealth holds promise as a gateway to reaching minority populations with diabetes. Because so many people have smartphones and they’re almost always near at hand, the device could serve as a platform for delivering personalized and timely messages about preventive care and medication adherence.
“Policy makers and healthcare administrators should continue to increase the accessibility of PHRs by making them easy to navigate and available on multiple platforms in order to reach patients with limited computer access or literacy.”
In their study, Chang and her colleagues say healthcare providers should take advantage of mobile device use among minorities to improve patient engagement strategies. But they also have to plan those strategies carefully.
“(I)t is important to recognize that individuals and households who rely on mobile devices as their only computer are often younger, lower-income, racial/ethnic minority populations who are more vulnerable to financial and technical constraints (e.g., cost of maintaining a cell phone plan, data allowances),” they wrote. “Further research is needed to better understand the barriers that these and other vulnerable populations (e.g., elderly patients or those with lower educational attainment) face in accessing patient portals.”
The two studies come at a time when healthcare providers are learning how to tailor mHealth outreach to targeted populations, ranging from those with specific health concerns to those in different age groups to minorities.
And as these studies point out, the challenges include not only finding the right message that will appeal to the target population, but making sure it’s delivered in the best possible format.