Older Adults’ Experience Using Patient Portals in Communities

Abstract

Patient portals can be beneficial for older adults who manage their own health. However, there is a lack of research on older adults' experience using patient portals in the community. The aim of this study was to assess older adults' perceived usability of patient portals they currently use. This was a secondary data analysis using selected baseline data from an online trial that tested the effects of a 3-week Theory-Based Patient Portal eLearning Program, and included 272 older adults recruited online. Data were analyzed using descriptive statistics and content analysis. Most participants owned patient portal accounts (n = 194 [71.3%]). Self-efficacy for using patient portals was relatively low (mean, 27.1; range, 0-40), and perceived usability of patient portals was also low (mean, 28.7; range, 6-42). The most-favored features of patient portals were review of medical information and eMessaging. The main difficulties in using patient portals were associated with login/access and specific portal functions. Managing multiple patient portals was a particular challenge for many participants. Findings from this study indicate the importance of providing proper levels of training and technical support to older adults to maximize use and improve outcomes of patient portal implementation.

Testing a Model of Patient Portal Use in Adult Patients

“…PP‐Related Variables. Two latent constructs of PP usability, ease of use and usefulness, were assessed using a modified 6‐item Perceived Health Web Site Usability Questionnaire on a 7‐point Likert scale (1 = strongly disagree or very unsatisfied ; 7 = strongly agree or very satisfied ; Cronbach’s α = 0.95; construct validity of the original scale was verified; Nahm, Resnick, & Mills, 2006; Son & Nahm, 2019): ease of use item 1: overall PP ease of use ease of use item 2: ease of completing tasks ease of use item 3: ease of reading information ease of use item 4: overall appearance of the site usefulness item 1: manage my health usefulness item 2: communicate with health care team …”

“…PP self‐efficacy was measured using the modified four‐item Self‐efficacy for Computer‐Based Personal Health Record (PHR) Scale on an 11‐point Likert scale (0 = not at all confident ; 10 = very confident ; Cronbach’s α = 0.94; construct validity of the original scale was tested; Nokes, Verkuilen, Hickey, James‐Borga, & Shan, 2013; Son & Nahm, 2019): self‐efficacy item 1: use PPs on my own self‐efficacy item 2: review records and use eMessages self‐efficacy item 3: keep track of health status self‐efficacy item 4: share information with others …”

“…Frequently identified usability issues included log‐in difficulties, complex navigation and functions, poor display of information, and use of jargon (Ali, Romero, Morrison, Hafeez, & Ancker, 2018). Such usability problems were more prominent among older adults and those with low socio‐economic status and limited eHealth literacy (Son & Nahm, 2019; Tieu et al, 2017). Lack of awareness and training on how to use portal functions and limited computer or Internet access were also found as common barriers (Graetz, Gordon, Fung, Hamity, & Reed, 2016; Nahm, Son, & Yoon, 2020).…”

Combining end-user recruitment methods for usability testing of eTriage Service

“…When testing e-health services such as eTriage Service, the ability of the end-users to understand health information or use different electronic services must be taken into account [6,17,19,20]. If the service is being tested only by experts it may cause bias in the usability problems that are related to the understanding of clinical terms.…”

“…According to crowdsourcing principles, people can be recruited online among ordinary service users. Online recruitment and remote testing has been used when conducting usability testing [17,20,23,25], and also in controlled randomized trials of self-management health interventions [26].…”