Addressing Rural Geographic Disparities Through Health IT Initial Findings From the Health Information National Trends Survey

Background: Rural communities experience disparate rates of chronic diseases and face distinct challenges in gaining access to health care. Increasing the reach of the US health information and communication technology infrastructure can support rural health by overcoming geographic and temporal health care barriers. Objectives: The goal of the study is to establish statistically valid point estimates for the use of health information technology within rural versus urban populations, and to understand the degree to which structural factors may account for the overall variance in the use of these technologies. Methods: Data from the National Cancer Institute's 2017 Health Information National Trends Survey were used to estimate prevalence of Health IT engagement across rural and urban populations and model factors influencing use of online medical records. Results: Rural residents reported similar rates of providers maintaining electronic health records and offering access to online medical records. However, rural residents with provider-maintained records were less likely to receive a provider recommendation to use online medical records and were subsequently less likely to actually access records. Observed differences in online medical record use were accounted for by variance in Internet access, access to a regular health care provider, and whether providers encouraged patients to use online records. Conclusions: Findings shed light on structural opportunities for overcoming geographic and temporal barriers to Health IT and extending the benefits of digital health information technologies to underserved populations.