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Purpose – The purpose of this paper is to present the cultural results of a three year study into the concept of information fulfilment and considers the impact of culture on levels of information fulfilment. Design/methodology/approach – Ethnographic studies were undertaken within higher education institutions in four countries, by examining each organization's shape and comparing it with the level of achievement of information fulfilment. The social and symbolic meanings that underpinned the culture of information in the chosen institutions are presented. The cultural frameworks are analysed and followed by a section of "raw data" from the ethnographic field. Findings – Culture impacted significantly in all the studies, and each study had its own unique character which provided rich insights into the culture, atmosphere and contexts of the fields. Originality/value – The relationships between the cultures and the levels of information fulfilment are reported with a view to helping build knowledge management systems that deliver higher levels of information fulfilment. [ABSTRACT FROM AUTHOR]

Background: Since the COVID-19 pandemic, telemedicine has been widely integrated into primary care pediatrics. While initial studies showed some concern for disparities in telemedicine use, telemedicine uptake for pediatric patients in a low-income, primarily Latino community over a sustained period has yet to be described., Objective: We aimed to assess the relationship between demographics, patient portal activation, and telemedicine visits, as well as characterize diagnoses addressed in telemedicine, in a low-income, primarily Latino population over time., Methods: A multidisciplinary team conducted outreach for telemedicine and patient portal activation with the adoption of a new electronic health record. Data were collected on all in-person and telemedicine visits from February 2020 through April 2021 for 4 community-based pediatric practices. The outcomes included patient portal activation, telemedicine use, and reason for telemedicine visits. Bivariate tests and multivariate regression analyses were conducted to assess the independent effects of demographics on the likelihood of portal activation and having a telemedicine visit. Telemedicine diagnoses were categorized, and subanalyses were conducted to explore variations by age and month., Results: There were 12,377 unique patients and 7127 telemedicine visits. Latino patients made up 83.4% (n=8959) of the population. Nearly all patients (n=10,830, 87.5%) had an activated portal, and 33.8% (n=4169) had at least 1 telemedicine visit. Portal activation decreased with age >2 years (2-4 years: adjusted odds ratio [aOR] 0.62, 95% CI 0.51-0.76; 5-11 years: aOR 0.28, 95% CI 0.23-0.32; 12-14 years: aOR 0.29, 95% CI 0.23-0.35; and 15-17 years: aOR 0.46, 95% CI 0.36-0.58). Spanish-speaking (aOR 0.52, 95% CI 0.45-0.59) and non-Latino patients (aOR 0.64, 95% CI 0.54-0.76) had decreased odds of activation and having a telemedicine visit (aOR 0.81, 95% CI 0.74-0.89 and aOR 0.71, 95% CI 0.62-0.81, respectively). The top 5 diagnostic categories for telemedicine were infectious disease (n=1749, 26.1%), dermatology (n=1287, 19.5%), gastrointestinal (n=771, 11.7%), well and follow-up care (n=459, 7%), and other specialty-related care (n=415, 6.3%). Infectious disease showed the most variation over time. Age-based patterns included a decrease in the proportion of infectious disease diagnoses by increasing age group and a higher proportion of well and follow-up care in older ages. Additional telemedicine diagnoses included common infant concerns for patients younger than 2 years of age; pulmonary, asthma, and allergy concerns for toddler or school-age children; behavioral health concerns for younger adolescents; and genitourinary and gynecologic concerns for older adolescents., Conclusions: The high engagement across demographics suggests feasibility and interest in telemedicine in this low-income, primarily Latino population, which may be attributable to the strength of outreach. Language-based disparities were still present. Telemedicine was used for a wide range of diagnoses. As telemedicine remains a vital component of pediatric health care, targeted interventions may enhance engagement to serve diverse pediatric patient populations., (©Priya R Pathak, Melissa S Stockwell, Mariellen M Lane, Laura Robbins-Milne, Suzanne Friedman, Kalpana Pethe, Margaret C Krause, Karen Soren, Luz Adriana Matiz, Lauren B Solomon, Maria E Burke, Edith Bracho-Sanchez. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 17.12.2024.)