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

The ability to access, manage, and understand personal health information enables individuals to become better healthcare consumers and to participate more fully with providers in making healthcare decisions. The development of electronic health records (EHRs), with the availability of electronic patient portals for accessing personal health information, has provided the potential for electronic personal health information management (ePHIM). There is great variability in access to the internet, electronic media, patient portals, and technology-based health (eHealth) information, across segments of the US population. It is essential that older adults have the eHealth literacy to understand and determine the veracity of information that they find through the internet and other digital sources.

The specific aims of this research were as follows:

• 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. 

There were three major components to this research. The first component entailed a qualitative research design that documented the ePHIM information, health information technology and personal health information management experience, knowledge, perceived needs, and perceived risks of low-income, multiethnic older adults. The second component measured actual use of the patient portal by older adults and their caregivers, and identified the factors associated with the use of the patient portal. The third component used a qualitative design to identify the differences in perception, belief, and experience between patients and caregivers who use versus those who do not use the patient portal.

The investigators found that increasing older adult internet use can improve access to health information and improve health self-management. Improving computer skills and limiting computer stress may be the keys to improving older adults’ eHealth use and understanding. Determining personal characteristics that are associated with limited internet use and eHealth literacy among older adults is important to understanding their prevalence, but these personal characteristics do not lead to improve use or literacy. Future research and intervention must continue to identify factors for improving technology use and eHealth literacy among older adults, and develop interventions that use these factors.