Human-Technology Interaction Factors Associated With the Use of Electronic Personal Health Records Among Younger and Older Adults: Secondary Data Analysis (Preprint)

Abstract

BACKGROUND An electronic personal health record (ePHR), also known as a personal health record (PHR), was broadly defined as an electronic application through which individuals can access, manage, and share their health information in a secure and confidential environment. Although ePHRs can benefit individuals as well as caregivers and healthcare providers, the use of ePHRs among individuals continues to remain low. The relationship between age and ePHRs use has been documented in previous studies, which indicated younger age was related to higher ePHRs use, and patients who are younger were more likely to use ePHRs. OBJECTIVE The current study aims to examine the relationship between human-technology interaction factors and ePHRs use among adults, and then compare the different effects of human-technology interaction factors on ePHRs use between younger adults (18-54 years old) and older adults (55 years of age and over). METHODS We analyzed the from the Health Information National Trends Survey (HINTS5, Cycle 3) collected from U.S. adults aged 18 years old and over in 2019. Descriptive analysis was conducted for all variables and each item of ePHRs use. Bivariate tests (Pearson test for categorical variable and F-test for continuous variables) were conducted over four age groups. Lastly, adjusting for socio-demographics and healthcare resources, a weighted multiple linear regression was conducted to examine the relationship between human-technology interaction factors and ePHRs use. RESULTS The final sample size was 1,363 and divided into two age groups: 18-54 years old and 55 years of age and older. The average level of ePHRs use was low (Mean=2.76, range=0-8). There is no significant difference on average ePHRs use between two age groups. Including clinical notes was positively related to ePHRs use in both groups: 18-54 years old (beta=0.28, P<0.01), 55 years old and above (beta=0.15, P<0.01). While accessing ePHRs using a smartphone app was only associated with ePHRs use among younger adults (beta=0.29, P<0.001), ease to understand health information in ePHRs was positively linked to ePHRs use only among older adults (beta=0.13, P<0.01). CONCLUSIONS This study found that including clinical notes was positively related to ePHRs use in both age groups, which suggested that including clinical notes as a part of ePHRs might improve the effective use of ePHRs among patients. Moreover, accessing ePHRs using a smartphone app was associated with higher ePHRs use among younger adults while ease of understanding health information in ePHRs was linked to higher ePHRs use among older adults. The design of ePHRs should provide the option of being accessible through mobile devices to promote greater ePHRs use among young people. For older adults, providers could add additional notes to explain health information recorded in the ePHRs.