217481 Bridging the digital divide: Medicare beneficiaries use of online health care services

Monday, November 8, 2010

Valerie Sue, PhD , Internet Services Group, Web Analytics, Kaiser Permanente, Oakand, CA
Jill Allen, PhD , Internet Services Group, Web Analytics, Kaiser Permanente, Oakland, CA
Background: The Internet provides unprecedented access to health information, clinical services and e-connectivity with health care providers; however, prevailing evidence suggests that the adoption of these services is not uniform across all demographic groups. Although seniors are enthusiastic consumers of health information, previous research indicates that they have been slow to adopt online health. Recent evidence points to a digital divide, impeding those most in need of care from accessing services. By contrast, data from a large integrated health plan demonstrate that seniors are embracing the full-range of online health offerings and are among the most active users of the plan's Web site.

Objectives: A. To describe Medicare beneficiaries who use the personal health record (PHR) and healthy living features on the plan's Web site and explore their usage patterns. B. To uncover the predictors of Web site utilization and satisfaction.

Methods: Web site usage data and an online survey of the plan's Medicare beneficiaries provided the foundation for these analyses. Data reduction strategies and hierarchical multiple regression techniques were used to evaluate the research hypotheses.

Results: More than 40% of the plan's Medicare beneficiaries were registered to use the Web site; registration was coupled with frequent use of the site. The PHR features most frequently accessed were: online appointment scheduling, e-mails to physicians, online lab test results and online prescription refill. Patients who have the greatest need for services were the most frequent users of PHR features; those who were the most health engaged were the highest users of non-PHR features. Health engagement was the strongest predictor of site utilization. Ease of use was the strongest predictor of site satisfaction.

Discussion: This research demonstrates that seniors will adopt and use online health services. Implications for improved health outcomes as a result of greater Web site utilization are discussed.

Learning Areas:
Other professions or practice related to public health
Program planning
Social and behavioral sciences

Learning Objectives:
1. Identify the features of a health care Web site that are used most frequently by senior members. 2. Explain the relationships among health engagement, need for services, perceived usefulness and ease of use in predicting site utilization and satisfaction. 3. Assess the value of health engagement and Web site use as they relate to improved health outcomes.

Keywords: Health Information Systems, Medicare

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-author of the study being presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.