Price-Haywood Eboni G, Harden-Barrios Jewel, Ulep Robin, Luo Qingyang
1 Ochsner Clinic Foundation, Center for Applied Health Services Research , New Orleans, Louisiana.
2 Ochsner Clinical School, University of Queensland , New Orleans, Louisiana.
Popul Health Manag. 2017 Dec;20(6):486-494. doi: 10.1089/pop.2016.0164. Epub 2017 Apr 6.
Innovations in chronic disease management are growing rapidly as advancements in technology broaden the scope of tools. Older adults are less likely to be willing or able to use patient portals or smartphone apps for health-related tasks. The authors conducted a cross-sectional survey of older adults (ages ≥50) with hypertension or diabetes to examine relationships between portal usage, interest in health-tracking tools, and eHealth literacy, and to solicit practical solutions to encourage technology adoption. Among 247 patients surveyed in a large integrated delivery health system between August 2015 and January 2016, eHealth literacy was positively associated with portal usage (OR [95% CI]: 1.3 [1.2-1.5]) and interest in health-tracking tools (1.2 [1.1-1.3]). Portal users compared to nonusers (N = 137 vs.110) had higher rates of interest in using websites/smartphone apps to track blood pressure (55% vs. 36%), weight (53% vs. 35%), exercise (53% vs. 32%), or medication (46% vs 33%, all P < 0.05). Portal users noted cumbersome processes for accessing portals and variations in provider availability for online scheduling and response times to messages. Portal nonusers expressed concerns about data security, lack of personalization, and limited perceived value of using portals. Both groups noted the importance of computer literacy and technical support. Patient stakeholders recommended marketing initiatives that capture patient stories demonstrating real-life applications of what patients can do with digital technology, how to use it, and why it may be useful. Health systems also must screen for eHealth literacy, provide training, promote proxy users, and institute quality assurance that ensures patients' experiences will not vary across the system.
随着技术进步拓宽了工具范围，慢性病管理方面的创新正在迅速发展。老年人不太愿意或不太能够使用患者门户网站或智能手机应用程序来完成与健康相关的任务。作者对患有高血压或糖尿病的老年人（年龄≥50岁）进行了一项横断面调查，以研究门户网站使用情况、对健康追踪工具的兴趣和电子健康素养之间的关系，并征求鼓励采用技术的实际解决方案。在2015年8月至2016年1月期间于一个大型综合医疗系统中调查的247名患者中，电子健康素养与门户网站使用情况（比值比[95%置信区间]：1.3[1.2 - 1.5]）和对健康追踪工具的兴趣（1.2[1.1 - 1.3]）呈正相关。与非用户相比（N = 137对110），门户网站用户对使用网站/智能手机应用程序追踪血压（55%对36%）、体重（53%对35%）、运动（53%对32%）或药物（46%对33%，所有P < 0.05）的兴趣更高。门户网站用户指出访问门户网站的过程繁琐，以及在线预约时提供者的可用性和对消息的响应时间存在差异。门户网站非用户对数据安全、缺乏个性化以及使用门户网站的感知价值有限表示担忧。两组都指出了计算机素养和技术支持的重要性。患者利益相关者建议开展营销活动，收集患者故事，展示患者使用数字技术可以做什么、如何使用以及为什么可能有用的实际应用。医疗系统还必须筛查电子健康素养，提供培训，推广代理用户，并建立质量保证措施，以确保患者在整个系统中的体验不会有所不同。
