Understanding barriers to medical instruction access for older adults

Abstract

Recalling medical instructions provided during a doctor's visit can be difficult due to access barriers, primarily for older adults who visit doctors multiple times per year and rely on their memory to act on doctor's recommendations. There are several interventions that aid patients in recalling information after doctors' visits; however, some have been proven ineffective, and those that are effective can present additional challenges for older adults. In this paper, we explore the challenges that older adults with chronic illnesses face when collecting and recalling medical instructions from multiple doctors' visits and discuss implications for AI-assisted tools to enable older adults better access medical instructions. We interviewed 12 older adults to understand their strategies for gathering and recalling information, the challenges they face, and their opinions about automatic transcription of their conversations with doctors to help them recall information after a visit. We found that participants face accessibility challenges such as hearing information and recalling medical instructions that require additional time or follow-up with the doctor. Therefore, patients saw potential value for a tool that automatically transcribes and helps with recall of medical instructions, but desired additional features to summarize, categorize, and highlight critical information from the conversations with their doctors. CCS CONCEPTS• Human-centered computing → Empirical studies in HCI; • Social and professional topics → Seniors.

Scribe

“…Based on a preliminary work with older adults [24], we defned three diferent fctitious scenarios to capture situations in which users visit a doctor and use Scribe during and after the visit: (1) recording notes from their conversations with the doctor, (2) reviewing the notes from a specifc previous visit, (3) forgetting to take a medicine after breakfast. For the frst and third scenario, we asked participants to complete one task and for the second scenario, participants were asked to complete three tasks.…”

“…Older adult patients face accessibility challenges including hearing impairments and recalling information as well as technical challenges when accessing e-health portals [24]. Older patients with hearing impairments often ask caregivers to accompany them for their medical visits and rely on their caregivers to collect and recall information provided during the visit [7,38].…”

“…Additionally, studies have shown that factors such as high amounts of information, stress, and complex medical terminologies (e.g., name of medications) can further hinder older patients' ability to recall information after the visit [41]. While e-health portals are becoming popular for exchanging information between doctors and patients, technological challenges when using e-health portals can prevent older adults from accessing lab results and other important information provided by their doctors [24]. Moreover, studies have shown that older patients experience user interaction issues (e.g., lack of content) and usability issues (e.g., difculty logging in), which hinders their ability to understand and navigate through portals [47].…”

“…There are three main features that guide Scribe's design: 1) enabling older adult patients to have access to a full transcript of the conversation with their doctors; 2) providing users with both a summary and key sections highlighting doctor's advice; and 3) enabling users to set reminders associated with a visit. These features were prioritized based on preliminary work examining older adults' experiences and challenges gathering and organizing information from doctor's visits [24]. In this work, we shared with older adults an example of a transcribed medical conversations and asked their opinions of how the tool may or may not be useful.…”