Sarah J Javier1,2, Lara K Troszak1,2, Stephanie L Shimada3,4,5, D Keith McInnes3,4, Michael E Ohl6,7, Tigran Avoundjian1,8, Taryn A Erhardt1,2, Amanda M Midboe1,2. 1. Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, California, USA. 2. Stanford School of Medicine, Stanford University, Stanford, California, USA. 3. Center for Healthcare Organization & Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA. 4. Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA. 5. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 6. Center for Comprehensive Access & Delivery Research and Evaluation (CADRE), Iowa City VA, Iowa City, Iowa, USA. 7. Department of Medicine, University of Iowa, Iowa City, Iowa, USA. 8. University of Washington School of Public Health, University of Washington, Seattle, Washington, USA.
Abstract
OBJECTIVE: To examine sociodemographic characteristics associated with use of My HealtheVet (MHV) by veterans living with HIV. MATERIALS AND METHODS: Veterans Health Administration administrative data were used to identify a cohort of veterans living with HIV in fiscal years 2011-2017. Descriptive analyses were conducted to examine demographic characteristics and racial/ethnic differences in MHV registration and tool use. Chi-Square tests were performed to assess associations between race/ethnicity and MHV registration and tool use. RESULTS: The highest proportion of registrants were non-Hispanic White veterans living with HIV (59%), followed by Hispanic/Latino (55%) and Black veterans living with HIV (40%). Chi-Square analyses revealed that: (1) MHV account registration was significantly lower for both Black and Hispanic/Latino veterans in comparison to White veterans and (2) Black MHV registrants were less likely to utilize any MHV tool compared with White MHV registrants including Blue Button record download, medication refills, secure messaging, lab, and appointment views. DISCUSSION: In line with prior research on personal health record (PHR) use among non-veteran populations, these findings show racial and ethnic inequities in MHV use among veterans living with HIV. Racial and ethnic minorities may be less likely to use PHRs for a myriad of reasons, including PHR privacy concerns, decreased educational attainment, and limited access to the internet. CONCLUSION: This is the first study to examine racial and ethnic disparities in use of MHV tools by veterans living with HIV and utilizing Veterans Health Administration health care. Future research should examine potential moderating factors linked to decreased PHR use among racial and ethnic minority veterans, which could inform strategies to increase PHR use among vulnerable populations. Published by Oxford University Press on behalf of the American Medical Informatics Association 2019.
OBJECTIVE: To examine sociodemographic characteristics associated with use of My HealtheVet (MHV) by veterans living with HIV. MATERIALS AND METHODS: Veterans Health Administration administrative data were used to identify a cohort of veterans living with HIV in fiscal years 2011-2017. Descriptive analyses were conducted to examine demographic characteristics and racial/ethnic differences in MHV registration and tool use. Chi-Square tests were performed to assess associations between race/ethnicity and MHV registration and tool use. RESULTS: The highest proportion of registrants were non-Hispanic White veterans living with HIV (59%), followed by Hispanic/Latino (55%) and Black veterans living with HIV (40%). Chi-Square analyses revealed that: (1) MHV account registration was significantly lower for both Black and Hispanic/Latino veterans in comparison to White veterans and (2) Black MHV registrants were less likely to utilize any MHV tool compared with White MHV registrants including Blue Button record download, medication refills, secure messaging, lab, and appointment views. DISCUSSION: In line with prior research on personal health record (PHR) use among non-veteran populations, these findings show racial and ethnic inequities in MHV use among veterans living with HIV. Racial and ethnic minorities may be less likely to use PHRs for a myriad of reasons, including PHR privacy concerns, decreased educational attainment, and limited access to the internet. CONCLUSION: This is the first study to examine racial and ethnic disparities in use of MHV tools by veterans living with HIV and utilizing Veterans Health Administration health care. Future research should examine potential moderating factors linked to decreased PHR use among racial and ethnic minority veterans, which could inform strategies to increase PHR use among vulnerable populations. Published by Oxford University Press on behalf of the American Medical Informatics Association 2019.
Entities:
Keywords:
HIV; health disparities; patient health record; race; veterans
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