Sociodemographic variation in use of and preferences for digital technologies among patients in primary care: Results from the OurCare national survey.

Objective: To assess the association between patient sociodemographic characteristics and adoption of and preferences for digital technologies in primary care.

Design: Cross-sectional bilingual online survey conducted in the fall of 2022.

Setting: Canada.

Participants: Adults living in Canada aged 18 and older.

Main outcome measures: Descriptive statistics were reviewed and a bivariate analysis was conducted of 8 outcomes by sociodemographic characteristic. Models included the following 8 self-reported characteristics: gender, age, province, level of education, level of income, rurality, whether the participant was born in Canada, and health status. Descriptive responses to a question on why video appointments were not important for some respondents were also examined.

Results: Data were analyzed from 9279 completed responses. Compared to those earning more than $150,000, respondents earning less than $30,000 were less likely to have recently used email or secure messaging (adjusted odds ratio [aOR]=0.57, 95% CI 0.37 to 0.87) or video calls (aOR=0.65, 95% CI 0.31 to 1.37) or want to use email or secure messaging (aOR=0.71, 95% CI 0.51 to 0.97) or video calls (aOR=0.50, 95% CI 0.36 to 0.68). Compared to university graduates, respondents with a high school diploma or below were less likely to have used email or secure messaging (aOR=0.67, 95% CI 0.49 to 0.90) or video calls (aOR=0.42, 95% CI 0.24 to 0.76) or want to use email or secure messaging (aOR=0.74, 95% CI 0.60 to 0.91) or video calls (aOR=0.73, 95% CI 0.59 to 0.90). People earning less than $30,000 were less likely to have accessed personal health records (aOR=0.43, 95% CI 0.30 to 0.61) or place importance on accessing them (aOR=0.60, 95% CI 0.41 to 0.88). Similarly, people with a high school diploma or less were less likely to access personal health records (aOR=0.61, 95% CI 0.50 to 0.76) and place importance on accessing them (aOR=0.68, 95% CI 0.54 to 0.86).

Conclusion: The results suggest that people living with a lower income or who have less formal education are less likely to have used digital technologies or consider them important. Further research and policy work should help to understand barriers to adoption of digital technologies and develop tailored interventions to enable equitable access to health care services.