“Everything is on the computer”: Understanding perceptions from an ethnically diverse sample of older adults

Purpose: To understand the beliefs of ethnically diverse older adults regarding their primary care physicians' (PCP) prescription information housed in the computer and how these beliefs affect their communication during medical visits. Background: Older adults frequently see many specialists and physicians to address their health care needs. Prescribing medications is the most common intervention in medical encounters. Methods: Using a maximum variation purposive stratified sample, we conducted 11 focus groups with 105 low-income Spanish speaking, black, and non-Hispanic white older adults in community settings. Focus group discussions centered on participant's perceptions about medications and what information is on their PCPs' computers. We used an iterative immersion crystallization group data analysis process. Results: The vast majority of participants believed that technology universally provides for the sharing of information between physicians, especially in the context of a referral system. Most participants also believed that PCPs and specialists communicated about patient care, and that the PCP was automatically and fully informed about prescriptions written by other physicians. Patients did not see value in keeping an updated medication list and bringing it to visits, and were also unclear how to negotiate between physicians when they did not have enough information about their medications. Conclusion: Older adults need to be made aware of what is actually included in computer systems and that the medical system is not totally integrated and information is not shared across doctors.