Improving older adults’ comprehension and use of patient portal-based health information

Within the next 40 years the number of older adults (over 65 years of age) in the world is expected to exceed the number of younger adults for the first time in history and in the United States they are the fastest growing segment of the population and the most frequent consumers of health information. Not surprisingly, the occurrence of chronic illnesses increases with age. Older adults constitute the most vulnerable demographic group, and while they are more likely to need to self-manage chronic illness, they are more disproportionally affected by inadequate health literacy and lower numeracy skills essential to self-care. Patient portal-based systems (e.g., Electronic Health Record) can improve patient care by providing more access to health information, however they are still underutilized by older adults, in part because they are hard to use and the information is often hard to understand. Because portals function more as repositories than collaborative tools, they do not engage patients and may not facilitate self-care. Our project is intended to improve use of portal information by older adults with diverse numeracy and literacy abilities, so that portals can better support patient-centered care. We describe the importance of theory, cognitive science of teaching and learning principles, and research methods in designing technology for older adults in the domain of health care. To exemplify this central argument, we adopt our framework to design and use EHR portal-based information, reducing the demands of comprehension and decision-making on health literacy and numeracy skills, and cognitive abilities more broadly.