AHRQ Report on barriers and drivers of health information technology use for the elderly, chronically ill, and underserved

Authors from the Oregon Evidence-based Practice Center have reviewed the evidence on the barriers and drivers to the use of interactive consumer health information technology (IT) by specific populations, namely the elderly, those with chronic conditions or disabilities, and the underserved.

They identified and reviewed 563 full-text articles and included 129 articles for abstraction. Of the studies that reported the impact of interactive consumer health IT on health outcomes, a consistent finding of their review was that these systems tended to have a positive effect when they provided a complete feedback loop that included:

• Monitoring of current patient status.
• Interpretation of this data in light of established, often individualised, treatment goals.
• Adjustment of the management plan as needed.
• Communication back to the patient with tailored recommendations or advice.
• Repetition of this cycle at appropriate intervals.

The most common factor influencing the successful use of the interactive technology by these specific populations was that the consumers’ perceived a benefit from using the system. Convenience was an important factor. It was critical that data entry not be cumbersome and that the intervention fit into the user’s daily routine. Usage was more successful if the intervention could be delivered on technology consumers used every day for other purposes. Finally, rapid and frequent interactions from a clinician improved use and user satisfaction.

Questions remain as to the optimal frequency of use of the system by the patient, which is likely to be condition-specific, as well as the optimal frequency of use or degree of involvement by health professionals. Also, does success depend on repeated modification of the patient’s treatment regimen or simply ongoing assistance with applying a static treatment plan? However, it is clear that the consumer’s perception of benefit, convenience, and integration into daily activities will serve to facilitate the successful use of the interactive technologies for the elderly, chronically ill, and underserved.

• Read the full report here
• Read the abstract here