A pioneering EMR-embedded digital health literacy tool reveals healthcare disparities for diverse older adults.

digital health literacy electronic medical records intersectional disparities older adults

Journal

Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062

Informations de publication

Date de publication:
29 Apr 2024
Historique:
revised: 28 03 2024
received: 02 11 2023
accepted: 29 03 2024
medline: 29 4 2024
pubmed: 29 4 2024
entrez: 29 4 2024
Statut: aheadofprint

Résumé

The COVID-19 pandemic transformed healthcare delivery with the rapid adoption of telehealth and digital technologies to access healthcare. Interventions are needed to ensure that older people in underserved communities do not face new technology-driven healthcare disparities. This article describes pioneering electronic medical record (EMR) embedded tools to assess and support each diverse patient's digital health literacy. We designed and validated a rapid EMR-embedded Digital Health Engagement Tool (DHET) to assess each patient's digital literacy in English and Spanish. We built a separate, EMR-generated auto-scoring function to assess patient use of telehealth and healthcare navigation as recorded within the EMR. Combined, the tools created a complete digital literacy assessment for each patient. We then deployed the tools to conduct a pilot study to elucidate disparities. A total of 112 ethnic/racial diverse older patients were enrolled (mean age was 78, ranging from 57 to 96) years (SD = 8.04). The female participants were 72.3%. Among the participants, non-Hispanic Whites were 47.3%; Hispanic 25.0%; non-Hispanic Asian 19.6%; non-Hispanic others (including multi-race and non-Hispanic Black/African Americans) 8.0%. Digital literacy disparities were revealed for older adults, particularly those over 70 years old, female gender, and those reporting relying on a helper. New EMR-embedded tools enable healthcare systems to assess the ability of patients to navigate and utilize EMR capabilities, such as video telehealth appointments, messaging providers, reviewing labs/radiology reports, and requesting prescriptions. The study identified significant challenges for older patients in navigating EMRs and calls for healthcare systems to better support patient learning.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic transformed healthcare delivery with the rapid adoption of telehealth and digital technologies to access healthcare. Interventions are needed to ensure that older people in underserved communities do not face new technology-driven healthcare disparities. This article describes pioneering electronic medical record (EMR) embedded tools to assess and support each diverse patient's digital health literacy.
METHODS METHODS
We designed and validated a rapid EMR-embedded Digital Health Engagement Tool (DHET) to assess each patient's digital literacy in English and Spanish. We built a separate, EMR-generated auto-scoring function to assess patient use of telehealth and healthcare navigation as recorded within the EMR. Combined, the tools created a complete digital literacy assessment for each patient. We then deployed the tools to conduct a pilot study to elucidate disparities.
RESULTS RESULTS
A total of 112 ethnic/racial diverse older patients were enrolled (mean age was 78, ranging from 57 to 96) years (SD = 8.04). The female participants were 72.3%. Among the participants, non-Hispanic Whites were 47.3%; Hispanic 25.0%; non-Hispanic Asian 19.6%; non-Hispanic others (including multi-race and non-Hispanic Black/African Americans) 8.0%. Digital literacy disparities were revealed for older adults, particularly those over 70 years old, female gender, and those reporting relying on a helper.
CONCLUSION CONCLUSIONS
New EMR-embedded tools enable healthcare systems to assess the ability of patients to navigate and utilize EMR capabilities, such as video telehealth appointments, messaging providers, reviewing labs/radiology reports, and requesting prescriptions. The study identified significant challenges for older patients in navigating EMRs and calls for healthcare systems to better support patient learning.

Identifiants

pubmed: 38682826
doi: 10.1111/jgs.18935
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : HRSA HHS
ID : U1QHP28724
Pays : United States

Informations de copyright

© 2024 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.

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Auteurs

Julie Rousseau (J)

Division of Geriatric Medicine and Gerontology, School of Medicine, University of California, Irvine, Irvine, California, USA.

Lisa Gibbs (L)

Division of Geriatric Medicine and Gerontology, School of Medicine, University of California, Irvine, Irvine, California, USA.

Carlos Garcia-Cabrera (C)

Program in Medical Education (PRIME), School of Medicine, University of California, San Diego, San Diego, California, USA.

Ava Runge (A)

Department of Internal Medicine, School of Medicine, University of California, San Francisco, San Diego, California, USA.

Christina Palmer (C)

Sue and Bill Gross School of Nursing, University of California, Irvine, Irvine, California, USA.

Jigar Haria (J)

Irvine Health, Information Systems Application, University of California, Irvine, California, USA.

Matthew Eichinger (M)

Irvine Health, Information Systems Application, University of California, Irvine, California, USA.

Jung-Ah Lee (JA)

Sue and Bill Gross School of Nursing, University of California, Irvine, Irvine, California, USA.

Classifications MeSH