Evidence map›Paper›PMID 39906363›Full record

ArticleJAMIA open2025

Using routinely available electronic health record data elements to develop and validate a digital divide risk score.

Jamie M Faro, Emily Obermiller, Corey Obermiller, Katy E Trinkley, Garth Wright, Rajani S Sadasivam, Kristie L Foley, Sarah L Cutrona, Thomas K Houston

Abstract read
In one paragraph

Article in JAMIA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jamie M FaroDepartment of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States.
Emily ObermillerDepartment of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27101, United States.
Corey ObermillerDepartment of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27101, United States.ORCID https://orcid.org/0009-0002-6948-0893
Katy E TrinkleyDepartment of Family Medicine, University of Colorado School of Medicine, Aurora, CO 80045, United States.ORCID https://orcid.org/0000-0003-2041-7404
Garth WrightDepartment of Clinical Pharmacy, University of Colorado School of Medicine, Aurora, CO 80045, United States.
Rajani S SadasivamDepartment of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States.
Kristie L FoleyDepartment of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC 27101, United States.
Sarah L CutronaDepartment of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States.
Thomas K HoustonDepartment of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27101, United States.

Funding

CTSA UM1 Program at Wake ForestUM1TR004929 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Jamy D Ard, KRISTIE L FOLEY · 2024 to 2026
$11.9M
iDAPT: Implementation and Informatics - Developing Adaptable Processes and Technologies for Cancer Control P50CA244693 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI DRESSLER, EMILY VAN METER · 2019 to 2023
$4.1M
Personalizing Clinical Decision Support for Heart Failure Treatment to Clinicians' NeedsK23HL161352 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI Katy E Trinkley · 2022 to 2026
$869k
ActivityChoice: A clinic-delivered implementation program to increase physical activity and decrease cardiovascular disease risk amongst cancer survivorsK01HL163254 · NHLBI · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI Jamie Faro · 2023 to 2026
$650k
NCATS NIH HHS UM1 TR004929NCI NIH HHS P50 CA244693NHLBI NIH HHS K01 HL163254NHLBI NIH HHS K23 HL161352
6 · The paper itself

Abstract

Background: Digital health (patient portals, remote monitoring devices, video visits) is a routine part of health care, though the digital divide may affect access. Objectives: To test and validate an electronic health record (EHR) screening tool to identify patients at risk of the digital divide. Materials and Methods: We conducted a retrospective EHR data extraction and cross-sectional survey of participants within 1 health care system. We identified 4 potential digital divide markers from the EHR: (1) mobile phone number, (2) email address, (3) active patient portal, and (4) >2 patient portal logins in the last year. We mailed surveys to patients at higher risk (missing all 4 markers), intermediate risk (missing 1-3 markers), or lower risk (missing no markers). Combining EHR and survey data, we summarized the markers into risk scores and evaluated its association with patients' report of lack of Internet access. Then, we assessed the association of EHR markers and eHealth Literacy Scale survey outcomes. Results: A total of 249 patients (39.4%) completed the survey (53%>65 years, 51% female, 50% minority race, 55% rural/small town residents, 46% private insurance, 45% Medicare). Individually, the 4 EHR markers had high sensitivity (range 81%-95%) and specificity (range 65%-79%) compared with survey responses. The EHR marker-based score (high risk, intermediate risk, low risk) predicted absence of Internet access (receiver operator characteristics Discussion: Each of the four EHR markers (Cell phone, email address, patient portal active, and patient portal actively used) compared with self-report yielded high levels of sensitivity, specificity, and overall accuracy. Conclusion: Using these markers, health care systems could target interventions and implementation strategies to support equitable patient access to digital health.

Indexed as

digital divideelectronic health recordhealth care accesshealth literacyscreening tool

Identifiers

PMID39906363
PMCPMC11792649

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.