Veterans' Communication Preferences for Primary Care Needs

BACKGROUND:
Health information that is exchanged in a comfortable, convenient, and preferred manner has the potential to influence healthcare choices and outcomes. Computer/Internet use represents a promising method of healthcare communication between patients and providers and has the potential to increase access to healthcare. Nearly 60% of U.S. adults use the Internet to look for healthcare information; however, limited information has been published about Veterans' use of computers and the Internet. This study examined computer and Internet use by Veterans in order to better understand patient preferences for health communication methods to meet a variety of primary care needs — and to assess the impact of computer use frequency on these preferences. Investigators conducted telephone interviews with 448 Veterans who received primary care at 14 VAMCs nationwide (urban and rural) in 2010. Interview questions focused on demographic and health characteristics, computer use, Internet use, and preferred methods of communicating with primary care providers for a number of healthcare-related reasons.

FINDINGS:

• Overall, 54% of the Veterans in this study reported being regular computer users (daily, 2-3 times per week, or once per week). On average, a greater proportion of infrequent users (2-3 times per month, less than once per month, or do not typically use a computer) were male, older, and in fair/poor health compared to regular users.
• Among Veteran primary care patients, telephone communication was preferred for the majority of primary care issues, including general medical questions, medication questions and refills, as well as preventive care reminders, scheduling, and test results. In-person visits were preferred for new medical conditions, concerns about ongoing conditions, treatment instructions, and information about next steps in care.
• Of regular computer users, about 1/3 preferred electronic communication (email or Internet portal, including MyHealtheVet) for preventive care reminders (37%), test results (34%), and prescription refills (32%).
• Veterans who used the Internet did so for a variety of reasons, with e-mail (85%) and accessing health information (39%) among the top two.

IMPLICATIONS:

• These findings can be used to plan patient-centered care that is aligned with Veterans' preferred health communication methods.

LIMITATIONS:

• Responses were self-report, which could cause recall bias.
• Lack of additional information about phone use (landline, cellular phone, smart phone) might be a limitation because patient communication preferences may differ for individuals based on the type of phone they typically use and the manner in which they use it (e.g., Internet access via phone).

AUTHOR/FUNDING INFORMATION:
Drs. LaVela, Locatelli, Gawron, and Weaver are part of HSR&D's Center for Management of Complex Chronic Care, Hines, IL. Dr. Schectman and Mr. Gering are part of VA's Office of Systems Redesign.

LaVela SL, Schectman G, Gering J, Locatelli S, Gawron A, and Weaver FM. Understanding Health Care Communication Preferences of Veteran Primary Care Users. Patient Education and Counseling September 2012;88(3):420-26.