title: Is the Digital Divide for Orthopaedic Trauma Patients a Myth? Prospective Cohort Study on Use of a Custom Internet Site.
abstract: OBJECTIVE
  Some have proposed that a so-called digital divide exists for orthopaedic trauma patients and that the clinical usefulness of the Internet for these patients is limited. No studies to date have confirmed this or whether patients would use a provided web resource. The hypotheses of this study were (1) a larger than expected percentage of trauma patients have access to the Internet and (2) if given access to a custom site, patients will use it.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Level 1 regional trauma center.
  
  
  METHODS
  Patients who were 18 years or older with acute operative fractures participated in this study. Enrollment was initiated either before discharge or at initial outpatient follow-up.
  
  
  METHODS
  We conducted a survey of demographics, Internet usage, device type, eHealth Literacy, and intent to use the web site. Participants received a keychain containing the web address and a unique access code to our custom orthopaedic trauma web site.
  
  
  METHODS
  Percentage of patients with Internet access and percentage of patients who visited the web site.
  
  
  RESULTS
  One hundred twelve patients were enrolled. Ninety-three percent (104/112) reported having Internet access (P < 0.0001). Only increasing age predicted lack of access (P < 0.015; odds ratio, 0.95). Most (95%, 106/112) planned to visit our site; however, only 11% (P < 0.001) accessed it.
  
  
  CONCLUSIONS
  The digital divide is a myth in orthopaedic trauma. Despite widespread access and enthusiasm for our web site, few patients visited. This cautions against the allocation of resources for patient-specific web sites for orthopaedic trauma until a rationale for use can be better delineated.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD; and †Department of Orthopaedics, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Matuszewski
authors.forename: Timothy
authors.initials: T
authors.lastname: Costales
authors.forename: Timothy
authors.initials: T
authors.lastname: Zerhusen
authors.forename: Max
authors.initials: M
authors.lastname: Coale
authors.forename: Samir
authors.initials: S
authors.lastname: Mehta
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Pollak
authors.forename: Robert V
authors.initials: RV
authors.lastname: OʼToole
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D066310:Digital Divide; D005260:Female; D006801:Humans; D015994:Incidence; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D014481:United States; D014947:Wounds and Injuries / Q000453:epidemiology / Q000601:surgery