Social Forces that Influence Health IT Use Behavior of the Elderly

Introduction

The healthcare industry is paying greater attention to improving patient outcomes through better provider-patient communication (Tang et al., 2013; Chrischilles et al.,2014). One such tool that is seeing greater utilization by healthcare providers is the patient portal. Patient portals are secure online websites that allow patients to access their personal health information, such as communicate summaries of recent visits, medications, immunizations, allergies, and lab results, from any location with an Internet connection (Krist et al., 2012; HealthIT.gov). More sophisticated patient portals are also capable of scheduling non-urgent appointments, downloading and submitting forms, processing prescription refills, accepting payments, and providing viewable educational material (Goldzweig et al., 2013). Patient portals have become a valuable tool for addressing the problem of rapidly aging populations in most countries (Bierman, 2012).

The use of electronic health records (EHR) is also on the rise. A 2014 study (Hsiao & Hing, 2014) shows that about 80% of office-based physicians in the US use EHRs, and a majority of them (69%) are committed to participate in the meaningful use incentive payment program available in the United States (Blumenthal & Tavenner, 2010). One of the Stage 2 Core Set objectives to achieve meaningful is “provide patients the ability to view online, download, and transmit their health information” (HealthIT.gov). This means that healthcare providers with EHR systems are mandated to provide patients with access to personal health information over the Internet using a secure online portal. Several other countries are introducing similar initiatives as they try to both improve health outcomes and strive for efficiencies in their health systems (Wickramasinghe, Davey, & Tatnall, 2013).

Numerous studies examine patient portal acceptance and use (Goldzweig et al., 2013; Ancker et al., 2011; Smith et al., 2015; Sarkar et al., 2011; Goel et al., 2011; Jung et al., 2011; Weppner et al., 2010). Patients with chronic conditions are more likely to accept and use patient portals (Goldzweig et al., 2013; Ancker et al., 2011; Millard & Fintak, 2002). Patient age is negatively correlated with portal adoption and use, especially among older patients (Goel et al., 2011; Jung, Padman, Shevchik, et al., 2011; Weppner et al., 2010). Roughly 20% of the US population will be over the age of 65 by 2030 in the next decade due to longer life spans and aging baby boomers (CDC, 2013), and it has been established that doctor visits and medical spending increase during the final years of life (Hogan, Lunney, Gabel, & Lynn, 2001). In fact, some studies indicate a quarter of an individual’s medical spending occurs in their final year (Lubitz & Riley, 1993). Hence, one can conclude that while older patients could benefit most from patient portals, they are the least likely group to use them.