Maximizing the Impact of ePHIM in Low-Income, Multiethnic Populations (North Carolina)

Project Final Report (PDF, 493.31 KB) Disclaimer

Summary:

The ability to access, manage, and understand personal health information enables individuals to become better consumers and participate more fully in making health care decisions. The development of electronic health records and the availability of patient portals for accessing personal health records, coupled with a myriad health information via the Internet provide the potential for electronic personal health information management (ePHIM). Despite continuing efforts, a “digital divide” remains for rural, minority, and low-income communities and limited access for ePHIM contributes to the health disparities experienced by these populations. The goal of this project is to improve the ability of low-income African American, American Indian, Latino, and white older adults living in rural and urban communities to use information technology applications for ePHIM.  

The specific aims of the project are to:  

  • Document the ePHIM experience, knowledge, perceived needs, and perceived risks of low-income African American, American Indian, Latino, and white older adults living in rural and urban communities.
  • Delineate the actual use of ePHIM by low-income African American, American Indian, Latino, and white older adults living in rural and urban communities.
  • Delineate differences in perception, belief, and experience in using ePHIM between patients and caregivers who use versus those who do not use ePHIM. 

The project’s conceptual framework combines the Technology Acceptance Model and the person-environmental interaction model. It uses a community-based participatory partnership the Wake Forest School of Medicine and its Outpatient Department Medicine Clinic and Community Partners HealthNet, a network of 18 clinics serving 25 rural North Carolina counties. Working with these networks, this project will implement in-depth and longitudinal research that will delineate the factors affecting ePHIM use among vulnerable populations.

Qualitative data collection techniques will be used to assess the motives and barriers to patients’ and caregivers’ ePHIM among rural, low-income, older adult, and minority communities. Emphasis will be on the importance of including caregivers, particularly for older adults, in understanding the use of ePHIM. Qualitative methods will also be used to assess the perceptions of health care providers and information technology providers about the potential use of ePHIM and determine the factors that facilitate and limit its use by comparing high (expert), medium, and low users. The actual pattern of ePHIM use will be documented among older adults and their caregivers over a one-year period. Finally, the project will explore the association of ePHIM use and chronic disease management among older adults.

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Maximizing the Impact of ePHIM in Low-Income, Multiethnic Populations - Final Report

Citation:
Bertoni A. Maximizing the Impact of ePHIM in Low-Income, Multiethnic Populations - Final Report. (Prepared by Wake Forest University Health Sciences under Grant No. R01 HS021679). Rockville, MD: Agency for Healthcare Research and Quality, 2019. (PDF, 493.31 KB)

The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
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