PHRs should undergo mixed-method testing to improve usability

Patient engagement through electronic personal health records (PHRs) should be evaluated in different ways to make them more useful for the intended consumers, according to a new study in eGEMs (Generating Evidence & Methods to improve patient outcomes).

Involving patients in their own care management with electronic tools is a major component of the Meaningful Use program, and in improving both individual and population health. However, PHRs still are not being used to a great extent.

The researchers, from Intel and the University of Florida, developed a self-assessment tool to prevent falls to be used with an electronic PHR by older adults (the SAPHeR System). They then tested the system for functionality and usability both in the laboratory via observational study and with 10 older adults in their homes using the systems. The system included features such as links to fall prevention videos located on different website, information on performing activities that improve balance, such as Tai Chi, and self-assessment questionnaires.

Other research has shown challenges in engaging patients in their care and significant differences in the acceptance and use of online patient tools by different consumer groups. It has been suggested that design and functionality issues also impede adoption of these tools.

The eGEMs study showed that task performance was slow, but the consumers still successfully completed the tasks. There were more errors with complex tasks, such as logging data in the self-monitoring activities. Also, certain design features may be more suitable for older adults, such as larger fonts; likewise, age can affect performance, such as the ability to click on certain icons.

"When designing consumer-facing health information management or self-management systems, there exists a trade-off between including features that support individual [i.e., tailored] or population [i.e., targeted] health promotion and health care management," the researchers said. "This type of functional analysis [that addresses both] can make apparent the design flaws that are related to user needs, technical limitations of existing infrastructures, and even designer bias."

To learn more:
- read the study (.pdf)