title: Facilitating out-of-home caregiving through health information technology: survey of informal caregivers' current practices, interests, and perceived barriers.
abstract: BACKGROUND
  Many patients with chronic conditions are supported by out-of-home informal caregivers-family members, friends, and other individuals who provide care and support without pay-who, if armed with effective consumer health information technology, could inexpensively facilitate their care.
  
  
  OBJECTIVE
  We sought to understand caregivers' use of, interest in, and perceived barriers to health information technology for out-of-home caregiving.
  
  
  METHODS
  We conducted 2 sequential Web-based surveys with a national sample of individuals who provide out-of-home caregiving to an adult family member or friend with a chronic illness. We queried respondents about their use of health information technology for out-of-home caregiving and used multivariable regression to investigate caregiver and care-recipient characteristics associated with caregivers' technology use for caregiving.
  
  
  RESULTS
  Among 316 out-of-home caregiver respondents, 34.5% (109/316) reported using health information technology for caregiving activities. The likelihood of a caregiver using technology increased significantly with intensity of caregiving (as measured by number of out-of-home caregiving activities). Compared with very low intensity caregivers, the adjusted odds ratio (OR) of technology use was 1.88 (95% CI 1.01-3.50) for low intensity caregivers, 2.39 (95% CI 1.11-5.15) for moderate intensity caregivers, and 3.70 (95% CI 1.62-8.45) for high intensity caregivers. Over 70% (149/207) of technology nonusers reported interest in using technology in the future to support caregiving. The most commonly cited barriers to technology use for caregiving were health system privacy rules that restrict access to care-recipients' health information and lack of familiarity with programs or websites that facilitate out-of-home caregiving.
  
  
  CONCLUSIONS
  Health information technology use for out-of-home caregiving is common, especially among individuals who provide more intense caregiving. Health care systems can address the mismatch between caregivers' interest in and use of technology by modifying privacy policies that impede information exchange.
authors.affiliation: Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA 94025, United States. donna.zulman@va.gov
authors.forename: Donna M
authors.initials: DM
authors.lastname: Zulman
authors.forename: John D
authors.initials: JD
authors.lastname: Piette
authors.forename: Emily C
authors.initials: EC
authors.lastname: Jenchura
authors.forename: Steven M
authors.initials: SM
authors.lastname: Asch
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Rosland
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers; D003625:Data Collection; D005260:Female; D006699:Home Care Services; D006801:Humans; D020407:Internet; D008297:Male; D008490:Medical Informatics; D008875:Middle Aged; D055815:Young Adult
keywords: caregivers; chronic disease; medical informatics