Universal Access in the Information Society

, Volume 12, Issue 2, pp 191–204 | Cite as

Older adults’ perceptions of usefulness of personal health records

  • Margaux M. Price
  • Richard Pak
  • Hendrik Müller
  • Aideen Stronge
Long Paper

Abstract

Electronic personal health records (PHRs) have the potential to both make health information more accessible to patients and function as a decision-support system for patients managing chronic conditions. Age-related changes in cognition may make traditional strategies of integrating and understanding existing (i.e., paper-based) health information more difficult for older adults. The centralized and integrated nature of health information, as well as the long-term tracking capabilities present in many PHRs, may be especially beneficial for older patients’ management of health. However, older adults tend to be late adopters of technology and may be hesitant to adopt a PHR if the benefits are not made clear (perceived usefulness). Toward the design of a useful PHR, a needs analysis was conducted to determine how people currently manage their health information, what they perceive as useful, and to identify any unmet needs. This paper describes two qualitative studies examining the health information needs of both younger and older adults. The first study used a 2-week diary methodology to examine everyday health questions or concerns, while the second study examined maintenance of health information and perceptions of PHRs through the use of a three-part interview. User’s perceptions of the usefulness of PHRs are provided as recommendations for the design of e-health technology, especially those targeted for older adult healthcare consumers. The results suggest that both older and younger adults would deem a PHR useful if it provides memory support in the form of reminders, provides tools to aid in comprehension of one’s health concerns, is interactive and provides automatic functions, and is highly accessible to authorized users, yet one’s information is kept secure and private.

Keywords

Personal health records Aging Technology adoption model Psychology Perceived usefulness 

References

  1. 1.
    Tang, P.C., Ash, J.S., Bates, D.W., Overhage, J.M., Sands, D.Z.: Personal health records: efinitions, benefits, and strategies for overcoming barriers for adoption. J. Am. Med. Inform. Assoc. 13, 121–126 (2006). doi:10.1197/jamia.M2025 CrossRefGoogle Scholar
  2. 2.
    Markle Foundation: Connecting Americans to their Healthcare (Final Report). http://www.markle.org/sites/default/files/eis_exec_sum_final_0704.pdf. Accessed 7 Apr 2011 (2004)
  3. 3.
    International Organization for Standardization: ISO/DTR 14292 Health Informatics—Personal Health Records: Definition, Scope, Context, and Global Variations of Use. http://www.iso.org/iso/iso_catalogue/catalogue_ics/catalogue_detail_ics.htm?ics1=35&ics2=240&ics3=80&csnumber=54568. Accessed 9 Sep 2011 (2011)
  4. 4.
    AHIMA Personal Health Record Practice Council: Helping consumers select PHRs: questions and considerations for navigating an emerging market. J. AHIMA 77(10), 50–56 (2006)Google Scholar
  5. 5.
    California Health Foundation: Consumers and Health Information Technology: A National Survey. http://www.chcf.org/~/media/Files/PDF/C/PDF%20ConsumersHealthInfoTechnologyNationalSurvey.pdf. Accessed 7 Apr 2011 (2010)
  6. 6.
  7. 7.
    Fox, S: E-Patients with a Disability or Chronic Disease. Pew Internet and American Life Project. http://pewinternet.org/pdfs/EPatients_Chronic_Conditions_2007.pdf6. Accessed 3 Feb 2009 (2007)
  8. 8.
    Centers for Disease Control and Prevention: National Diabetes Fact Sheet. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. Accessed 7 Apr 2011 (2011)
  9. 9.
    Craik, F.I.M., Byrd, M.: Aging and cognitive deficits: the role of attentional resources. In: Craik, F.I.M., Trehub, S.E. (eds.) Aging and Cognitive Processes, pp. 191–211. Plenum, New York (1982)CrossRefGoogle Scholar
  10. 10.
    Maylor, E.A.: Aging and forgetting in prospective memory and retrospective memory tasks. Psychol. Aging 8, 420–428 (1993). doi:10.1037/0882-7974.11.1.74 CrossRefGoogle Scholar
  11. 11.
    Liu, L.L., Park, D.C.: Technology and the promise of independent living for adults: a cognitive perspective. In: Charness, N., Schaie, K.W. (eds.) Impact of Technology on Successful Aging, pp. 270–274. Springer, New York (2003)Google Scholar
  12. 12.
    Davis, F.D., Bagozzi, R.P., Warshaw, P.R.: User acceptance of computer technology: a comparison of two theoretical models. Manag. Sci. 35, 982–1003 (1989). doi:10.1287/mnsc.35.8.982 CrossRefGoogle Scholar
  13. 13.
    International Organization for Standardization: ISO/DTR 14292: Guidance on Usability (1998)Google Scholar
  14. 14.
    Chaffin, A.J., Maddux, C.D.: Accessibility accommodations for older adults seeking e-health information. J. Gerontol. Nurs. 33, 6–12 (2007)Google Scholar
  15. 15.
    Marchionini, G., Rimer, B.K., Wildemuth, B.: Evidence Base for Personal Health Record Usability Final Report to the National Cancer Institute. http://www.ils.unc.edu/phr/files/final%20report%20010307.pdf. Accessed 7 Apr 2011 (2007)
  16. 16.
    Marziali, E.: The design and evaluation of e-health intervention programs for older adults. eHealth Int. J. 4, 6–13 (2008)Google Scholar
  17. 17.
    Siek, K., Kahn, D.U., Ross, S.E..: A usability inspection of medication management in three personal health applications. In: Kurosu, M. (ed.) Human Centered Design, pp. 129–138. Springer, Berlin (2009)CrossRefGoogle Scholar
  18. 18.
    Peters, K., Niebling, M., Slimmer, C., Green, T., Webb, J.M., Schumacher, R.: Usability Guidance for Improving the User Interface and Adoption of Online Personal Health Records. http://www.usercentric.com/publications/2009/02/02/google-health-vs-microsoft-healthvault-consumers-compare-online-personal-hea. Accessed 2 Feb 2010 (2009)
  19. 19.
    Ma, Q., Liu, L.: The technology acceptance model: a meta-analysis of empirical findings. J. Orga. End User Comput. 16, 59–72 (2004). doi:10.4018/joeuc.2004010104 CrossRefGoogle Scholar
  20. 20.
    Melenhorst, A.S., Rogers, W.A., Bouwhuis, D.G.: Older adults’ motivated choice for technological innovation: evidence for benefit-driven selectivity. Psychol. Aging 21, 190–195 (2006). doi:10.1037/0882-7974.21.1.190 CrossRefGoogle Scholar
  21. 21.
    Melenhorst, A.S., Rogers, W.A., Caylor, E.C.: The use of communication technologies by older adults: exploring the benefits from the user’s perspective. In: Proceedings of the Human Factors and Ergonomics Society 45th Annual Meeting, Minneapolis, pp. 221–225 (2001)Google Scholar
  22. 22.
    Angst, C., Agarwal, R., Downing, J.: An Empirical Examination of the Importance of Defining the PHR for Research and for Practice. In: Proceedings of the 41st Annual Hawaii International Conference on System Sciences, Waikoloa, Hilton, p 10 (2008)Google Scholar
  23. 23.
    Morgan, D.L.: The Focus Group Guidebook: Focus Group Kit, vol. 1. Sage, Thousand Oaks (1998)Google Scholar
  24. 24.
    Bolger, N., Davis, A., Rafaeli, E.: Diary methods: capturing life as it is lived. Annu. Rev. Psychol. 54, 579–616 (2003). doi:10.1146/annurev.psych.54.101601.145030 CrossRefGoogle Scholar
  25. 25.
    Baddeley, A., Eysenck, M.W., Anderson, M.C.: Memory. Psychology Press, New York (2009)Google Scholar
  26. 26.
    Kim, E., Mayani, A., Modi, S., Soh, C.B., Kim, Y.: Evaluation of patient-centered electronic health record to overcome digital divide. Conf. Proc. IEEE Eng. Med. Biol. Soc. 2, 593–596 (2005)Google Scholar
  27. 27.
    Vetere, F., Davis, H., Gibbs, M., Howard, S.: The magic box and collage: responding to the challenge of distributed intergenerational play. Int. J. Hum. Comput. Stud. 67, 165–178 (2009). doi:10.1016/j.ijhcs.2008.09.004 CrossRefGoogle Scholar
  28. 28.
    Yarosh, S., Cuzzort, S., Müller, H., Abowd, G.D.: Developing a media space for remote synchronous parent-child interaction. In: Proceedings of the 8th International Conference on Interaction Design and Children IDC, vol. 09, pp. 97–105. doi:10.1145/1551788.1551806 (2009)
  29. 29.
    Gefen, D., Karahanna, E., Straub, D.W.: Trust and TAM in online shopping: an integrated model. MIS Q. 27, 51–90 (2003)Google Scholar
  30. 30.
    Tang, P.C., Lansky, D.: The missing link: bridging the patient-provider health information gap. Health Aff. 24, 1290–1295 (2005). doi:10.1377/hlthaff.24.5.1290 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Margaux M. Price
    • 1
  • Richard Pak
    • 1
  • Hendrik Müller
    • 2
  • Aideen Stronge
    • 3
  1. 1.Department of PsychologyClemson UniversityClemsonUSA
  2. 2.Google, Inc.New YorkUSA
  3. 3.Google, Inc.SeattleUSA

Personalised recommendations