Paper Summary: Patient Adoption and Utilization of a Web-Based and Mobile-Based Portal for Collecting Outcomes After Elective Orthopedic Surgery
Abena Ansah-Yeboah  |  November 26, 2018
A recent paper published in March 2018 sought to analyze how age affects patient portal engagement via web-based and mobile-based platforms. As multiple studies have shown, patients engaged in their healthcare decisions are more likely to obtain better outcomes, and technologies such as patient portals, mobile apps, and telemedicine have become instrumental in facilitating this process. There exists a general assumption of increased technology engagement by younger patients, however, although patients above 70 years old are less likely to create mobile health (mHealth) accounts, those who do tend to sign in more frequently than patients in any other age group. Despite an overall lower participation, are older patients more active in using digital health technologies?
A cohort of 17,133 orthopedic patients from a single multispecialty clinic were retrospectively reviewed in order to evaluate age and sex patterns across both web- and and mobile-app patient outcomes reported (PRO) systems. Individuals ranged from ages 18 - 96 with over half of the sample composed of female patients. In summary, the main findings of the study revealed that patient portal and mobile app usage does, indeed, vary with age, and middle-aged patients most engaged with these technologies. The breakdown of the collected data is as follows:
  • Patients between the ages 41 to 50 years logged in most frequently to portals.
  • Patients between the ages 51 to 60 years messaged clinical providers most frequently.
  • Patients between the ages 61 to 70 were more compliant with PRO completion.
  • Patients between the ages 31 to 65 years old were most likely to register and use online patient portals.
A majority of current age-related technology research focuses either young adults or seniors, and, as such, the observed high usage of of patient portals in middle-aged Americans is quite interesting. In this study, both the youngest and oldest patient groups were least likely to utilize portals and provide PROs likely due to low interest and limited access to technology. For young adults, not only are members of this age group having to newly manage their healthcare decisions, they are also, typically, a demographic with fewer medical conditions to worry about. As for older individuals, although 80% of senior adults have a cell phone, only 42% of these devices are smartphone. Similarly 64% of seniors have Internet access, and for those aged 75+ years, this number drops significantly to 47%. Adopting new technology can be difficult for older adults, with issues such as physical disabilities, declines in cognitive abilities, skeptical attitudes, and financial concerns.
Possible explanations for high middle-aged usage include difficulty contacting clinic offices for appointment scheduling, medication refills, or test results due to workday time restrictions. Another reason could stem from the more active role this age group plays in simultaneously caring for children and elder relatives, make middle-aged adults more interested in electronic health record (EHR) systems. Perhaps there is simply a greater needed for health-related services as adults age and encounter more medical issues, thus making this group more proactive in caring for their health. Whatever the case, it is critical that digital health companies formulate strategies for consumer engagement that differ by patient population, specifically age demographics.