international journal of medical informatics 77 ( 2 0 0 8 ) 778–786 journal homepage: www.intl.elsevierhealth.com/journals/ijmi Access to and use of the Internet by South African general practitioners Ken Masters * ITHealthEd, Köstendorf, Austria article info Article history: Received 21 August 2007 Received in revised form 31 March 2008 Accepted 27 May 2008 Keywords: Internet Family practice Health care surveys South Africa Developing countries abstract Introduction: In the developed world, doctors use the Internet to support the delivery of health care. Their usage patterns are explained by Rogers’ Diffusion of Innovations. There is no knowledge of Internet usage by doctors in the developing world. Methods: In July 2006, 2600 survey forms were posted in the first national survey of South African (SA) General Practitioners’ (GPs) use of the Internet. A sample of non-responders was followed up. The aim was to determine SA GPs’ Internet usage patterns, to compare them to world usage, and to examine them in the light of Diffusion of Innovations. Results: A 10% usable response rate was a major weakness, but similar surveys are unlikely to be more representative. 89% of SA GPs have Internet access, home usage is high, and overall usage patterns are equivalent to the usage patterns of international studies. Discussion: In spite of the overall technological under-development in South Africa, as pre- dicted by Diffusion of Innovations, SA GPs have adopted the technology, and use it for health care in much the same way as their international counterparts. Further studies on some of the details will be valuable. Conclusion: The indications are that SA GPs will reap the benefits of the Internet as it con- tinues to evolve, and translate these into improved health care delivery in South Africa. © 2008 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Numerous publications discuss the need for doctors to maintain expertise through formal and informal Continuing Medical Education (CME) (e.g. [1,2]), to remain in contact with colleagues (e.g. [3,4]) and also to maintain good communica- tion with patients (e.g. [5,6]). Internationally, doctors’ use of the Internet has been stud- ied widely, by both independent researchers and medical associations, in the USA, Canada, and Europe [7]. A systematic literature review of these and other studies conducted by the author [7] revealed that, on average, doctors’ use of the Inter- net is higher than their national averages, and is increasing. Doctors use the Internet for general medical research and per- ∗ Tel.: +43 664 4982 076. E-mail address: kmasters@ithealthed.com. sonal use, accessing a wide range of sites including journals, CME sites, financial sites, and, to a lesser extent, to maintain contact with colleagues and patients. Males tend to use the Internet more than females, and young more than old, but these figures are not consistent across all studies, and appear to be equalising. 1.1. Theoretical background In that review, the results were discussed in the light of Rogers’ Diffusion of Innovations (DoI) [8,9]. DoI was able to explain how the Internet’s ability to meet doctors’ professional needs for high quality health care delivery drove their adoption of 1386-5056/$ – see front matter © 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijmedinf.2008.05.008