Are we ready for Telemedicine? Trends in Health Information Technology (HIT) use among the U.S population 2012-2018 (Preprint)

BACKGROUND The pandemic forced clinicians to pivot to offering services via telehealth, but it is unclear whether and which patients (users of care) were equipped to use digital health. This is especially pertinent for those adults managing chronic diseases, such as obesity, hypertension, and diabetes, which require regular follow medication management, and self-monitoring. OBJECTIVE To measure the trends and assess factors affecting Health Information Technology Use among US population with and without cardiovascular risk factors. METHODS We used serial cross-sectional National Health Interview Survey (NHIS) data from the years 2012 and 2018 was used to assess trends in health information technology (HIT) use among adults, stratified by age and cardiovascular risk factor status. A linear trend analysis was performed to observe the annual percentage change (APC) in HIT use from the years 2012 to 2018 by age, education, and cardiovascular risk status. We developed multivariate logistic regression models adjusted for age, sex, race, insurance status, marital status, geographic region, and perceived health status to assess the likelihood of HIT use among patients with and without cardiovascular disease risk factors. RESULTS 14,304 (44.6%) and 14,644 (58.7%) participants reported using HIT in 2012 and 2018, respectively. When comparing the rates of HIT use for the years 2012 and 2018 respectively, among participants without cardiovascular risk factors, the HIT use proportion increased from 51.1% to 65.8%, with one risk factor increased from 43.9% to 59%, and with more than one risk factor increased from 41.3% to 54.7%. Increasing trends in HIT use were highest among adults aged >65 years (APC: 8.3%), who had more than one CVD risk factors (APC: 5%), and among those who did not have high school graduation (APC: 8.8%). Likelihood of HIT use was significantly higher in younger, female, non-Hispanic white, higher education and income, married, and individuals reporting very good or excellent health status. In 2018, college graduates were 7.18 (95% CI: 5.86,8.79), 6.25 (5.02,7.78), 7.80 (5.87,10.36) times more likely to use HIT compared to adults without high school education among people with multiple, one, or no cardiovascular risk factors, respectively. CONCLUSIONS Over 2012-2018, HIT use increased nationally, with greater use noted among younger and higher educated U.S. adults. Targeted strategies are needed to engage a wider age-, race-, education-, and socioeconomic groups through lowering barriers to HIT access and utilization.