Examining Individuals' Use of the Internet for Health Care Activities Over Time: Results from the US National Health Interview Survey.

backgroundTelehealth is an increasingly important component of health care services. Telehealth services may present an opportunity to increase the equity, accessibility, and effectiveness of health care. As such, it is critical that telehealth design focuses on reducing the barriers to access and usability that may impair some telehealth users.

objectiveOur goal was to identify different demographic characteristics, behaviors, or opinions that may predict groups who are likely to face a barrier to using telehealth services.

methodsWe used data from the National Health Interview Survey and multiple logit regression models focused on different aspects of telehealth to examine three different avenues of telehealth service: looking up health information using the internet, scheduling an appointment using the internet, and communicating with a care provider through email using the internet in order to consider the ways in which different telehealth services may face different barriers.

resultsOur results suggest that middle-aged (36-55 years old) and older adult (56-85 years old) respondents were significantly less likely to look up health information using the internet or schedule an appointment using the internet versus younger individuals (18-35 years old). Specifically, our analysis found that middle-aged adults were found to have a higher odds ratio than older adults (0.83 vs 0.65) for looking up health information using the internet. We also found that there were differences in age groups for using technology to perform health care-related tasks. In terms of searching for health information using the internet and scheduling appointments using the internet, we found differences between men and women, with women being significantly more likely than men to look up health information using the internet, schedule an appointment using the internet, and communicate with a care provider through email using the internet. Across all the investigated variables, we found that the rates of using the internet for looking up health information, scheduling an appointment, and communicating with a care provider over email increased substantially across the study period. The impact of costs was inconsistent across the different models in our analysis. We also found that there is a strong correlation between respondents' collaboration in their personal health and the likelihood that they would use telehealth services to meet these needs.

conclusionsThis analysis provides an exploratory look at the data to highlight barriers that may impact a user's ability to access telehealth services in the context of other potential predictor variables to account for the real-world variability that these may present. Future work should examine the complex relationships of those variables and understand how these interactions are correlated with the respondents' use of telehealth.