Friday, March 18, 2016

This Is A Very Important Study Which Has Huge Relevance For The Hoped For Success Of The mHR.

This study appeared last week.

Elderly black, Latino patients less likely to use health organization's online portal

March 7, 2016 | By Katie Dvorak
Patients who are over the age of 69 and black or Latino are less likely to use a health organization's online patient portal, and organizations that serve elderly populations should be aware of such disparities, according to a recent study.
Researchers at Kaiser Permanente locations in California and Oregon found that adults older than 69 were "significantly" less likely to have access to a patient portal, according to the study published in the Journal of Medical Internet Research (JMIR). Older patients who did have portal access were less likely to use the tool to send messages, view lab results and refill prescriptions.
The study also found that black and Latino consumers were less likely to use a portal. Only about 26 percent of black members between the ages of 75 and 79 used a portal once, compared to about 56 percent of non-Hispanic white patients.
The researchers survey portal use by 183,565 non-Hispanic white members, 16,898 black members, 12,409 Latino members, 11,896 Filipino members and 6,314 Chinese members, all between 65 and 79 years old.
A recent study in the Journal of the American Medical Informatics Association also found differences in the use of portals by various consumer groups. Of 534 older adults with online patient portal access in the Chicago area, almost all had the access code to register for the portal, but only 57.5 percent actually registered. Men, whites and those with fewer chronic conditions were more likely to register. In addition, the Office of the National Coordinator for Health IT found that while the number of people using IT for their health needs increased "significantly" between 2013 and 2014, socio-demographic disparities remain.
The JMIR study also found that only 31 percent of participants had a smartphone; however, about 80 percent had access to a desktop or laptop computer.
Lots more here:
What this confirms is that in all likelihood  many of the elderly and the disadvantaged are going to be very challenged to make use of a portal, even which is more useful and functional than the mHR is ever planned, or can be. Even if you inflict a record on all these people I suspect they will never use it and even if they do, probably won’t understand what they are looking at in many cases.
Given this older population is a key target of the mHR and it is really unlikely it will help many of them this is yet another reason for Government to stop the mHR nonsense and maybe try some properly evidence based approaches to the use of e-Health to assist the care of the elderly.

1 comment:

Terry Hannan said...

David, your posting is timely and appropriate. An interesting statistic from December 2015 revealed that there were 7.1 billion people in the world and 7.4 billion mobile devices with probably less than 10 mHealth projects being shown to be effective in health care delivery.
The following is a direct cut and paste from a discussion on GHDOnline where I am a Moderator. Alain is very happy for his materials to be disseminated and he is at the forefront of mHealth (global) evaluation. Terry

Alain Labrique, PhD, MHS, MS started a discussion in Health IT:
Over the past decade, the global "mobile phone" revolution has inspired 1000's of global health innovation projects. Clinicians and public health practitioners have been working with NGOs and governments to leverage the ubiquity of phones and connectivity across once-remote, rural populations as a way of overcome barriers to scale-up programs. A major obstacle in the way of widespread adoption of these "mHealth" innovations, at scale, has been the absence of guidelines from normative bodies like WHO. This stems from the lack of quality reporting to provide an evidence-base of the mHealth work which is being done around the world.

The mHealth Evaluation, Reporting and Assessment (mERA) guidelines represents the FIRST step in this direction - as WHO commissioned a team, including researchers from Johns Hopkins Global mHealth Initiative and the WHO/HRP mHealth Technical Evidence Group (mTERG), to develop standard criteria for reporting research and innovation findings.

mERA seeks to standardize the reporting of mHealth findings and promote the expansion of the evidence base by:
Supplementing existing reporting standards to provide a concrete checklist of criteria specific to reporting on digital innovations
Elaborating on the existing criteria to support high-quality methodological reporting of evidence

These guidelines, will be added to a growing library of standards which have helped move research - from large clinical trials to observational studies - forward significantly. These reporting guidelines also aim for better comparison of research findings, as well as to combine experiences across different settings to advocate for innovations which can improve patient experiences around the globe.

For the WHO mHealth Technical Evidence Review Group (mTERG),

Alain B. Labrique, PhD, MHS, MS
Director, Johns Hopkins University Global mHealth Initiative
Associate Professor, Program in Global Disease Epidemiology and Control
Department of International Health & Department of Epidemiology (jt.), Bloomberg School of Public Health
Division of Health Sciences Informatics, School of Medicine (jt.)
Department of Community-Public Health, School of Nursing (jt.)