BackgroundPersonal health records (PHRs) are increasingly being deployed worldwide, but their rates of adoption by patients vary widely across countries and health systems. Five main categories of adopters are usually considered when evaluating the diffusion of innovations: innovators, early adopters, early majority, late majority, and laggards.ObjectiveWe aimed to evaluate adoption of the Portuguese PHR 3 months after its release, as well as characterize the individuals who registered and used the system during that period (the innovators).MethodsWe conducted a cross-sectional study. Users and nonusers were defined based on their input, or not, of health-related information into the PHR. Users of the PHR were compared with nonusers regarding demographic and clinical variables. Users were further characterized according to their intensity of information input: single input (one single piece of health-related information recorded) and multiple inputs. Multivariate logistic regression was used to model the probability of being in the multiple inputs group. ArcGis (ESRI, Redlands, CA, USA) was used to create maps of the proportion of PHR registrations by region and district.ResultsThe number of registered individuals was 109,619 (66,408/109,619, 60.58% women; mean age: 44.7 years, standard deviation [SD] 18.1 years). The highest proportion of registrations was observed for those aged between 30 and 39 years (25,810/109,619, 23.55%). Furthermore, 16.88% (18,504/109,619) of registered individuals were considered users and 83.12% (91,115/109,619) nonusers. Among PHR users, 32.18% (5955/18,504) engaged in single input and 67.82% (12,549/18,504) in multiple inputs. Younger individuals and male users had higher odds of engaging in multiple inputs (odds ratio for male individuals 1.32, CI 1.19-1.48). Geographic analysis revealed higher proportions of PHR adoption in urban centers when compared with rural noncoastal districts.ConclusionsApproximately 1% of the country’s population registered during the first 3 months of the Portuguese PHR. Registered individuals were more frequently female aged between 30 and 39 years. There is evidence of a geographic gap in the adoption of the Portuguese PHR, with higher proportions of adopters in urban centers than in rural noncoastal districts.

This paper addresses the timely and internationally relevant problem of designing a national integrated personal health record. Health care reforms around the world are changing the way health-related activities are performed. The goal is to empower patients to gain control of their healthcare information and foster health care team collaboration through integrated national health information systems. To accomplish this goal it is urgent to engage users in the use of these platforms. We present the process for creating a meaningful design strategy for a citizen portal that incorporates an integrated personal health record. This portal is part of a national health data platform crosschannel experience, connecting health care providers with patients, counting over 750,000 users. We applied a user experience design process to create an effective design solution for an integrated PHR and prototype that can be extended to the development of this new type of PHR.

Prior evidence shows that senior people accept technology and enjoy self-monitoring. Home telehealth support increases their confidence and sense of security. The use of communication technologies plays an important role avoiding isolation and loneliness. This paper presents a qualitative study of 7 seniors, 4 nurses, 2 physicians and the program manager of a nationwide senior telehealth program. The program targets the follow-up of senior people aged over 70 years old with about 24.000 participants. In order to minimize social isolation and promote healthy behaviours, nurses contact seniors through periodical phone-calls, applying a comprehensive geriatric assessment to evaluate their physical, mental and social wellbeing. Our findings show and compare the perspectives from the several program stakeholders, evaluating their interest in the adoption of a complementary web channel with an integrated personal health record. We present user experience concerns and directions that derive from the interviews' outcomes of our study to design senior telehealth multi-channel platforms.

Along with aging, technological changes are felt as a way to assist, maintain and extend life. Assistive technology allows people to stay comfortable in their homes increasing their sense of confidence and security. The research reported here has the goal to empower seniors on their daily lives. We designed a proposal for an Integrated Personal Health Record for the improvement of a Nation-wide Patient Portal. We also involved the project stakeholders of the Portal on a user-centered design process to engage new users into the platform. Currently, we are exploring the design of an online channel for a recently launched National Telehealth Senior Program. Seniors have the potential of interacting with both systems and have an integrated view over their health; access their medical records and geriatric assessments; use online healthcare services e.g., scheduling appointments; finally, contribute with self-collected data such as observations of the daily living to monitor their health and provide more patient knowledge to healthcare providers.

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