Consumers' Perceptions of Patient-Accessible Electronic Medical Records

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Abstract

Background

Electronic health information (eHealth) tools for patients, including patient-accessible electronic medical records (patient portals), are proliferating in health care delivery systems nationally. However, there has been very limited study of the perceived utility and functionality of portals, as well as limited assessment of these systems by vulnerable (low education level, racial/ethnic minority) consumers.

Objective

The objective of the study was to identify vulnerable consumers’ response to patient portals, their perceived utility and value, as well as their reactions to specific portal functions.

Methods

This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June and July 2010, in New York City.

Results

Participants included 10 males and 18 females, ranging in age from 21-63 years; 19 non-Hispanic black, 7 Hispanic, 1 non-Hispanic White and 1 Other. None of the participants had higher than a high school level education, and 13 had less than a high school education. All participants had experience with computers and 26 used the Internet. Major themes were enhanced consumer engagement/patient empowerment, extending the doctor’s visit/enhancing communication with health care providers, literacy and health literacy factors, improved prevention and health maintenance, and privacy and security concerns. Consumers were also asked to comment on a number of key portal features. Consumers were most positive about features that increased convenience, such as making appointments and refilling prescriptions. Consumers raised concerns about a number of potential barriers to usage, such as complex language, complex visual layouts, and poor usability features.

Conclusions

Most consumers were enthusiastic about patient portals and perceived that they had great utility and value. Study findings suggest that for patient portals to be effective for all consumers, portals must be designed to be easy to read, visually engaging, and have user-friendly navigation.

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Social Media Use in the United States: Implications for Health Communication

Wen-ying Chou, Yvonne M Hunt, Ellen Beckjord … (2009)

Background Given the rapid changes in the communication landscape brought about by participative Internet use and social media, it is important to develop a better understanding of these technologies and their impact on health communication. The first step in this effort is to identify the characteristics of current social media users. Up-to-date reporting of current social media use will help monitor the growth of social media and inform health promotion/communication efforts aiming to effectively utilize social media. Objective The purpose of the study is to identify the sociodemographic and health-related factors associated with current adult social media users in the United States. Methods Data came from the 2007 iteration of the Health Information National Trends Study (HINTS, N = 7674). HINTS is a nationally representative cross-sectional survey on health-related communication trends and practices. Survey respondents who reported having accessed the Internet (N = 5078) were asked whether, over the past year, they had (1) participated in an online support group, (2) written in a blog, (3) visited a social networking site. Bivariate and multivariate logistic regression analyses were conducted to identify predictors of each type of social media use. Results Approximately 69% of US adults reported having access to the Internet in 2007. Among Internet users, 5% participated in an online support group, 7% reported blogging, and 23% used a social networking site. Multivariate analysis found that younger age was the only significant predictor of blogging and social networking site participation; a statistically significant linear relationship was observed, with younger categories reporting more frequent use. Younger age, poorer subjective health, and a personal cancer experience predicted support group participation. In general, social media are penetrating the US population independent of education, race/ethnicity, or health care access. Conclusions Recent growth of social media is not uniformly distributed across age groups; therefore, health communication programs utilizing social media must first consider the age of the targeted population to help ensure that messages reach the intended audience. While racial/ethnic and health status–related disparities exist in Internet access, among those with Internet access, these characteristics do not affect social media use. This finding suggests that the new technologies, represented by social media, may be changing the communication pattern throughout the United States.

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Health disparities across the lifespan: meaning, methods, and mechanisms.

Norma J. Stewart, Paul N. Adler (2010)

Over the past two decades, exponential growth of empirical research has fueled markedly increased concern about health disparities. In this paper, we show the progression of research on socioeconomic status (SES) and health through several eras. The first era reflected an implicit threshold model of the association of poverty and health. The second era produced evidence for a graded association between SES and health where each improvement in education, income, occupation, or wealth is associated with better health outcomes. Moving from description of the association to exploration of pathways, the third era focused on mechanisms linking SES and health, whereas the fourth era expanded on mechanisms to consider multilevel influences, and a fifth era added a focus on interactions among factors, not just their main effects or contributions as mediators. Questions from earlier eras remain active areas of research, while later eras add depth and complexity.

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New directions in eHealth communication: opportunities and challenges.

Gary L Kreps, Linda Neuhauser (2010)

This article reviews key communication issues involved in the design of effective and humane eHealth applications to help guide strategic development and implementation of health information technologies. There is a communication revolution brewing in the delivery of health care and the promotion of health fueled by the growth of powerful new health information technologies. The development, adoption, and implementation of a broad range of new eHealth applications (such as online health information websites, interactive electronic health records, health decision support programs, tailored health education programs, health care system portals, mobile health communication programs, and advanced telehealth applications) holds tremendous promise to increase consumer and provider access to relevant health information, enhance the quality of care, reduce health care errors, increase collaboration, and encourage the adoption of healthy behaviors. With the growth of new and exciting health information technology opportunities, however, comes the daunting responsibility to design interoperable, easy to use, engaging, and accessible eHealth applications that communicate the right information needed to guide health care and health promotion for diverse audiences. Copyright 2010. Published by Elsevier Ireland Ltd.

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Author and article information

Contributors

Christina Zarcadoolas:

CUNY School of Public Health at Hunter College2180 Third Avenue #547New York, NY, 10035United States1 212 396 77451 212 396 7638czarcado@hunter.cuny.edu

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications Inc. (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: August 2013

Publication date (Electronic): 26 August 2013

Volume: 15

Issue: 8

Electronic Location Identifier: e168

Affiliations

[1] ¹CUNY School of Public Health at Hunter College New York, NYUnited States

[2] ²Department of Psychiatry and Behavioral Sciences University of Miami Miller School of Medicine Miami, FLUnited States

[3] ³Joslyn Levy & Associates, LLC New York, NYUnited States

[4] ⁴Department of Biomedical Informatics Columbia University New York, NYUnited States

Author notes

Corresponding Author: Christina Zarcadoolas czarcado@ 123456hunter.cuny.edu

Article

Publisher ID: v15i8e168

DOI: 10.2196/jmir.2507

PMC ID: 3758049

PubMed ID: 23978618

SO-VID: b08301d7-b6de-4d51-adf3-99b2838a0bcd

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 20 December 2012

Date revision requested : 20 January 2013

Date revision received : 18 March 2013

Date accepted : 13 June 2013

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