Internet Use Study

Assessment of computer and Internet use in cardiac in-patients (Internet Access Survey)


Principal Investigator: Scott Lear Co-investigators: Yuriko Araki, Biljana Maric, Annemarie Kaan, Dan Horvat The Internet Access Study was conducted in 2006 in order to determine the depth and breadth of Internet access for patients with cardiovascular disease living in British Columbia, for the purpose of developing and evaluating the delivery of web-based cardiac services to patients in their homes. Of 294 cardiovascular disease patients surveyed from regions across British Columbia, 66% had home Internet access. In rural areas, 47% had Internet access compared to those living in areas with populations over 10 000 (63%) and 100 000 (72%), respectively (p=0.020). Over half of the patients accessed the Internet daily with 70% using it to access health information. The findings from this study showed that health care organizations can take advantage of the Internet to develop and evaluate the delivery of cardiac services to patients in their homes. This would be particularly advantageous for patients in rural and remote communities with limited access to direct health care.

Background

To date, the majority of government and health authority sponsored telehealth service initiatives in Canada have focused on the transfer of images or consultation services that require sophisticated and costly video conferencing networks situated in hospitals or clinics. This has helped to facilitate communication between rural and large urban centres with respect to acute care but is not a feasible alternative for those with chronic conditions such as cardiovascular disease (CVD) that require more frequent, less intensive feedback between patient and provider. It has become clear that patients living outside of urban centres do not have access to the same level of care as those in cities.

Objectives

The purpose of this study was to identify the determinants of Internet use in patients with cardiovascular disease and the patterns of use. The use of the Internet may provide an alternative that is less expensive and readily accessible in most Canadian communities. In addition, Internet based services may provide solutions in urban environments that already experience maximal utilization of resources.

Methodology

Cardiac inpatients of an urban tertiary and a northern regional hospital in British Columbia were invited to participate. Those who could not speak English or who had mental impairment were excluded. Consenting patients were interviewed regarding demographics and home Internet use. Participants underwent a structured interview regarding socio-demographics, location of residence, admission indication, home ownership of a computer and home Internet access. Those participants who indicated they had home Internet access were asked about the type of access (i.e., connection type), reasons and frequency of use, and who the main household user was. All participants were asked if they accessed the Internet outside of home and those without home Internet access were asked to identify possible barriers to their ability to use the Internet for health purposes. Using Statistics Canada definitions, participants were categorized based on their place of residence as either living in a census metropolitan area (CMA) with an urban core population greater than 100 000; a census agglomeration (CA) area with an urban core population 10 000 to 99 999; or a rural area (i.e., all other areas).

Results

A total of 294 patients participated in the study. The average age of the participants was 64.0 ± 12.7 years. Most participants were men (68%) of European ancestry (77%) with some post-secondary education (57%). Participants came from all five BC provincial health authorities. A total of 193 (66%) of patients had home Internet access. Of those living in rural areas, 47% had Internet access compared to 63% and 72% for those living in areas with a population above 10,000 and 100,000 respectively. Eighty-four percent of patients with Internet access reported having a high-speed connection, 55% reported using the Internet daily, and 23% used it more than once per week. Accessing health information was reported by 70% of patients.

Conclusion

The data indicates a high penetration of Internet use among English-speaking cardiac patients and their inclination to obtain health information online. The results support the use of the Internet as a viable medium to deliver health care services. Health care organizations can take advantage of the Internet to develop and evaluate the delivery of cardiac services to patients in their homes. This would be particularly advantageous for patients in rural and remote communities.