title: Access, interest, and attitudes toward electronic communication for health care among patients in the medical safety net.
abstract: BACKGROUND
  Electronic and internet-based tools for patient-provider communication are becoming the standard of care, but disparities exist in their adoption among patients. The reasons for these disparities are unclear, and few studies have looked at the potential communication technologies have to benefit vulnerable patient populations.
  
  
  OBJECTIVE
  To characterize access to, interest in, and attitudes toward internet-based communication in an ethnically, economically, and linguistically diverse group of patients from a large urban safety net clinic network.
  
  
  METHODS
  Observational, cross-sectional study
  
  
  METHODS
  Adult patients (≥ 18 years) in six resource-limited community clinics in the San Francisco Department of Public Health (SFDPH) MAIN MEASURES: Current email use, interest in communicating electronically with health care professionals, barriers to and facilitators of electronic health-related communication, and demographic data-all self-reported via survey.
  
  
  RESULTS
  Sixty percent of patients used email, 71 % were interested in using electronic communication with health care providers, and 19 % reported currently using email informally with these providers for health care. Those already using any email were more likely to express interest in using it for health matters. Most patients agreed electronic communication would improve clinic efficiency and overall communication with clinicians.
  
  
  CONCLUSIONS
  A significant majority of safety net patients currently use email, text messaging, and the internet, and they expressed an interest in using these tools for electronic communication with their medical providers. This interest is currently unmet within safety net clinics that do not offer a patient portal or secure messaging. Tools such as email encounters and electronic patient portals should be implemented and supported to a greater extent in resource-poor settings, but this will require tailoring these tools to patients' language, literacy level, and experience with communication technology.
authors: Department of Pediatrics, University of California San Francisco, 505 Parnassus Avenue, M691, San Francisco, CA, 94143, USA. Adam.schickedanz@ucsf.edu
authors: Adam
authors: A
authors: Schickedanz
authors: David
authors: D
authors: Huang
authors: Andrea
authors: A
authors: Lopez
authors: Edna
authors: E
authors: Cheung
authors: C R
authors: CR
authors: Lyles
authors: Tom
authors: T
authors: Bodenheimer
authors: Urmimala
authors: U
authors: Sarkar
mesh_terms: D000328:Adult; D001292:Attitude to Computers; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods / Q000639:trends*; D034742:Electronic Mail / Q000639:trends*; D005260:Female; D006801:Humans; D020407:Internet / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D064876:Safety-net Providers / Q000379:methods / Q000639:trends*; D060145:Text Messaging / Q000639:trends*