Chou, Wen‐Ying Sylvia

The contemporary healthcare system can help improve health literacy outcomes in two ways: first, by nurturing the skills and motivations needed for patients to be actively engaged in their own health and healthcare decisions; and, second, by creating a prepared and proactive healthcare system that adapts to patients’ capacities and needs in efficacious ways. In 2001, the National Cancer Institute launched the Health Information National Trends Survey (HINTS) as a way for researchers and planners to understand how the public is interacting with a rapidly changing health information environment. Original iterations of the HINTS national probability sampling strategies took place on a biennial basis, but in subsequent years the protocol moved to a yearly administration. This yields a rich resource of cross-sectional, national surveillance data to evaluate for trends across and within vulnerable populations. Sixteen studies are presented from the published literature to illustrate how HINTS data were used to explore constructs of direct interest to health literacy researchers. Suggestions are given for how this ongoing public surveillance mechanism can be used: (a) to provide a sentinel view of how the public is interacting with information in the environment to address their health needs; (b) to generate research questions and hypotheses for further exploration using complementary methodologies; and (c) to explore the diffusion of new health communication channels within and between segments of the national population.

Abstract The increasing adoption of electronic health records (EHRs) in the United States, spurred largely by the Centers for Medicare and Medicaid's EHR Meaningful Use Incentive Program, has potential to increase patient engagement and improve quality of healthcare delivered, especially for those diagnosed with cancer or other chronic conditions. Meaningful Use Stage 2 criteria require that providers give patients the ability to view, download and transmit their medical records; this is of particular importance for cancer patients, whose care is often delivered by teams of different specialists and for whom accurate communication of medical and treatment history between patients and providers is critical. To investigate whether there is a difference in patient access to and utilization of EHRs based on history of cancer diagnosis, we analyzed data from the National Cancer Institute's Health Information National Trends Survey (HINTS 4, Cycle 4). The survey was fielded between July and November 2014 via postal mail; 3,370 complete surveys were returned (response rate = 34.4%). Of the respondents, 6.4% reported having a prior diagnosis of a cancer other than non-melanoma skin cancer. Among those with a self-reported history of cancer, 48.2% reported being offered access to their EHRs and 30.8% accessed their EHRs at least once, compared with those who did not have cancer (41.8% and 27.2%, respectively; p > 0.05). After adjusting for sociodemographic and healthcare-related characteristics, no significant difference was found in the odds of being offered EHR access based on cancer diagnosis status. Those with a history of cancer had a statistically significantly higher odds of accessing their EHRs at least once compared to those without a diagnosis of cancer after adjustment, (OR = 1.75, 95% CI = 1.08-2.81, p = 0.02). Other significant predictive factors included in the model were age, education, health insurance, having a regular provider, and internet access (p < 0.05). A borderline association was also seen between a previous cancer diagnosis and increased frequency of EHR access (p = 0.08). These findings suggest that, if offered access to their records, those with a diagnosis of cancer have higher odds of using their EHRs; further investigation is needed to determine how patients are using EHRs to help manage their care, the impact of this use on cancer-specific outcomes, and associations with quality of care. Citation Format: Alexandra J. Greenberg, Angela Falisi, Lila J. Finney Rutten, Wen-Ying Sylvia Chou, Richard P. Moser, Bradford W. Hesse. Cancer diagnoses and patient use of electronic health records: results from the health information national trends survey. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2573.