Challenges to using an electronic personal health record by a low-income elderly population.
Challenges to using an electronic personal health record by a low-income elderly population.
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DOI：
10.2196/jmir.1256
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发表时间：
2009-10-27
影响因子：
7.4
通讯作者：
Kim Y
中科院分区：
文献类型：
--
作者：
Kim EH;Stolyar A;Lober WB;Herbaugh AL;Shinstrom SE;Zierler BK;Soh CB;Kim Y
电子个人健康记录 (PHR) 越来越得到认可，并被用作解决当代美国医疗保健系统中存在的分散且不兼容的个人健康信息所带来的各种挑战的工具。尽管近年来围绕 PHR 开发和部署的活动有所增加，但有关低收入和/或老年人群中 PHR 的使用和效用的报道却很少。 目的是评估 PHR 在低收入老年人群中的使用和效用。 我们在联邦资助的低收入和老年居民住房设施中部署了基于网络、机构中立的 PHR 系统，即个人健康信息管理系统 (PHIMS)。我们通过系统日志、问卷调查和用户组会议来评估使用情况和用户满意度。 在 33 个月的研究期间，70 名居民参与了研究；到研究结束时，这个数字减少到 44。尽管 PHIMS 是免费提供个人协助的，并且向居民免费提供了可连接互联网的计算机，但只有 13% (44/330) 的合格居民使用了该系统，并且系统使用量有限。几乎一半的用户（47%，33/70）仅在一天内使用过 PHIMS。使用情况也与能否获得现场帮助高度相关； 77% 的用户活动发生在可以获得帮助的情况下。居民使用 PHR 系统的能力受到计算机和互联网技能差、技术恐惧症、健康素养低以及身体/认知能力有限的限制。在 44 名 PHIMS 用户中，有 14 名（32%）回答了调查问卷。在这个选定的调查参与者亚组中，大多数（82%，9/11）使用 PHIMS 三次或以上，并报告说它提高了他们所接受的整体医疗保健的质量。 我们的研究结果表明，那些能够从 PHR 系统中受益最多的人可能是最没有能力使用它的人。计算机、互联网和 PHR 的获取和使用方面的差异可能会加剧未来的医疗保健不平等。
Electronic personal health records (PHRs) are increasingly recognized and used as a tool to address various challenges stemming from the scattered and incompatible personal health information that exists in the contemporary US health care system. Although activity around PHR development and deployment has increased in recent years, little has been reported regarding the use and utility of PHRs among low-income and/or elderly populations. The aim was to assess the use and utility of PHRs in a low-income, elderly population. We deployed a Web-based, institution-neutral PHR system, the Personal Health Information Management System (PHIMS), in a federally funded housing facility for low-income and elderly residents. We assessed use and user satisfaction through system logs, questionnaire surveys, and user group meetings. Over the 33-month study period, 70 residents participated; this number was reduced to 44 by the end of the study. Although the PHIMS was available for free and personal assistance and computers with Internet connection were provided without any cost to residents, only 13% (44/330) of the eligible residents used the system, and system usage was limited. Almost one half of the users (47%, 33/70) used the PHIMS only on a single day. Use was also highly correlated with the availability of in-person assistance; 77% of user activities occurred while the assistance was available. Residents’ ability to use the PHR system was limited by poor computer and Internet skills, technophobia, low health literacy, and limited physical/cognitive abilities. Among the 44 PHIMS users, 14 (32%) responded to the questionnaire. In this selected subgroup of survey participants, the majority (82%, 9/11) used the PHIMS three times or more and reported that it improved the quality of overall health care they received. Our findings suggest that those who can benefit the most from a PHR system may be the least able to use it. Disparities in access to and use of computers, the Internet, and PHRs may exacerbate health care inequality in the future.
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DOI：
10.1197/jamia.m2562
发表时间：
2008-01-01
影响因子：
6.4
作者：
Halamka, John D.;Mandl, Kenneth D.;Tang, Paul C.
通讯作者：
Tang, Paul C.
影响因子：
4.4
作者：
Gustafson, DH;McTavish, FM;Hawkins, R
通讯作者：
Hawkins, R
DOI：
10.1197/jamia.m1672
发表时间：
2005-03-01
影响因子：
6.4
作者：
Hsu, J;Huang, J;Ortiz, E
通讯作者：
Ortiz, E
DOI：
10.1089/dis.2007.104706
发表时间：
2007-08-01
期刊：
DISEASE MANAGEMENT
影响因子：
--
作者：
Follen, Marilyn;Castaneda, Rachel;Higuchi, Keiko
通讯作者：
Higuchi, Keiko
影响因子：
7.4
作者：
Frost JH;Massagli MP
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Massagli MP