Factors affecting cancer patients' electronic communication with providers: Implications for COVID-19 induced transitions to telehealth.

ABSTRACT

OBJECTIVE: Because of the pandemic, electronic communication between patients and clinicians has taken on increasing significance in the delivery of cancer care. The study explored personal, clinical, and technology factors predicting cancer survivors' electronic communication with clinicians. METHODS: Data for this investigation came from the Health Information National Trends Survey (HINTS5, Cycle 2) that included 593 respondents who previously or currently had cancer. Multivariate regression analyses were used to predict electronic communication with clinicians. Predictors included demographic variables and health status, technology use (online health information-seeking behavior, tracking of health-related data such as using a Fitbit), and quality of past communication experiences with clinicians. RESULTS: In this pre COVID-19 sample, 42 % respondents (N = 252) did not engage in any type of electronic communication (e.g., emailing, texting, data sharing) with providers. In multivariate analyses, predictors of more electronic communication with clinicians included frequency of seeking health-related information online (ß = .267, p < .001) and better communication experiences with clinicians (ß = .028, p = .034), while no demographic variable showed significance. The technology use variables (online health information seeking, health tracking) were significantly higher predictors of electronic communication with clinicians (ΔR2 = .142, p < .001) than was past experiences with clinicians (ΔR2 = .029, p = .016). CONCLUSIONS: Access and past experience with interactive media technologies are strong predictors of cancer patients' electronic communication than with clinicians. Adoption of telehealth technology likely depends as much on patients' relationships with technology as it does their relationships with clinicians. PRACTICE IMPLICATIONS Since Covid-19, cancer care providers have turned to telehealth provide patients with needed cancer care services. Enhancing patients' digital competence and experience with electronic communication will help them more easily navigate telehealth care. Providers can leverage their relationship with patients to facilitate more effective use of telehealth services.