Are EHRs creating a digital divide for the elderly?

A digital divide could be developing between the elderly who can access their records online and those who cannot, researchers recently warned in JAMA Internal Medicine.

The study looked at Internet use in a national survey of about 19,000 Americans who were at least 65 years old and who did not live in nursing homes. The proportion who reported using the Internet in any way doubled from 21 percent in 2002 to 42 percent in 2010. Yet that varied by group characteristics and health status.

People with functional impairments, such as loss of a sense or the ability to walk, can have more difficulty in using a patient portal to view their health data. That's something providers working toward the patient engagement requirement in Stage 2 of the Meaningful Use incentive program need to consider.

"If you look at the subgroup of people functionally impaired, there was also a doubling [of Internet use] there, but it was still remarkably low," lead author, S. Ryan Greysen, from the University of California, San Francisco, told Reuters.

The biggest gains were found among groups that started with the lowest usage rates--those age 75 years old and older, not white or who considered themselves to be in poor or fair health.

Internet use among those with functional impairment grew from 10 percent in 2002 to 23 percent in 2010. Unless their use of the Internet grows, these people could be left behind as healthcare increasingly goes digital, Greysen and his colleagues said.

People with functional impairments might need more assistance than just being shown how to access a patient portal, the authors said. They might need software that reads web pages aloud or the ability to operate a computer using voice commands. What's more, the authors said, healthcare providers might need to enlist caregivers to help them access their health information.

A Kaiser Permanente study published earlier this year found that diabetic patients who used a patient portal to refill their prescription cholesterol medication improved their medication adherence and cholesterol levels, illustrating portals' potential benefits. Still, usability of technology remains a concern for older patients.

Another study warned that diabetes-management apps pose particular problems for older users.

To learn more:
- find the abstract
- read the Reuters story

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