Trends of online patient-provider communication among cancer survivors from 2008 to 2017: a digital divide perspective.

PURPOSE: In the past decade, online patient-provider communication (OPPC) has emerged as a viable avenue for cancer survivors to communicate with their providers. However, little is known about the patterns of OPPC among cancer survivors. Thus, the current study aims to explore the trend of OPPC used by cancer survivors, and the influence of digital divide on OPPC in the past decade.

METHODS: Data from the 2008, 2011, 2013, and 2017 iterations of the nationally representative survey of Health Information National Trends Survey (HINTS) were analyzed. Only cancer survivors were included in the analyses. Descriptive analyses and multivariate regressions were performed.

RESULTS: Email has been the most typical means of OPPC; its adoption rate has increased from 9.7 to 36.6% in the past 10 years. More options for OPPC (e.g., mobile app, social medial, video conferencing, electronic health records) have been adopted since 2013. Physical Internet access was a significant predictor of OPPC over the four iterations, while cognitive access failed to predict OPPC in all the four waves. The effect of socio-demographic access varied vastly across iterations, with greater influences in 2017.

CONCLUSIONS: This study illustrates an increasing trend in OPPC use among cancer survivors. Significant digital divide barriers also exist in the adoption and diffusion of OPPC.

IMPLICATIONS FOR CANCER SURVIVORS: OPPC is an important communication channel for cancer survivors and will become more important in the digital era. Targeted interventions to address the digital divide barriers affecting OPPC could be developed to benefit underserved cancer survivors and to bridge health disparities.