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Does neurocognition contribute to age-related deficits in the online navigation of electronic patient health portals?

Published online by Cambridge University Press:  09 February 2023

Anastasia Matchanova Open the ORCID record for Anastasia Matchanova [Opens in a new window] ,
Michelle A. Babicz Open the ORCID record for Michelle A. Babicz [Opens in a new window] ,
Victoria M. Kordovski ,
Savanna M. Tierney ,
Samina Rahman ,
Luis D. Medina ,
Clint Cushman  and
Steven Paul Woods
Anastasia Matchanova
Affiliation:
Department of Psychology, University of Houston, Houston, USA
Michelle A. Babicz
Affiliation:
Department of Psychology, University of Houston, Houston, USA Mental Health and Behavioral Services, James A. Haley Veterans’ Hospital, Tampa, USA
Victoria M. Kordovski
Affiliation:
Department of Psychology, University of Houston, Houston, USA Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, USA
Savanna M. Tierney
Affiliation:
Department of Psychology, University of Houston, Houston, USA Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
Samina Rahman
Affiliation:
Department of Psychology, University of Houston, Houston, USA Department of Psychology, Washington State University, Washington, USA
Luis D. Medina
Affiliation:
Department of Psychology, University of Houston, Houston, USA
Clint Cushman
Affiliation:
Department of Psychiatry, University of California, San Diego, USA
Steven Paul Woods*
Affiliation:
Department of Psychology, University of Houston, Houston, USA
*
Corresponding author: Steven Paul Woods, email: spwoods@uh.edu
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Abstract

Objective:

The internet serves an increasingly critical role in how older adults manage their personal health. Electronic patient portals, for example, provide a centralized platform for older adults to access lab results, manage prescriptions and appointments, and communicate with providers. This study examined whether neurocognition mediates the effect of older age on electronic patient portal navigation.

Method:

Forty-nine younger (18–35 years) and 35 older adults (50–75 years) completed the Test of Online Health Records Navigation (TOHRN), which is an experimenter-controlled website on which participants were asked to log-in, review laboratory results, read provider messages, and schedule an appointment. Participants also completed a neuropsychological battery, self-report questionnaires, and measures of health literacy and functional capacity.

Results:

Mediation analyses revealed a significant indirect effect of older age on lower TOHRN accuracy, which was fully mediated by the total cognitive composite.

Conclusions:

Findings indicate that neurocognition may help explain some of the variance in age-related difficulties navigating electronic patient health portals. Future studies might examine the possible benefits of both structural (e.g., human factors web design enhancement) and individual (e.g., training and compensation) cognitive supports to improve the navigability of electronic patient health portals for older adults.

Keywords

agingneuropsychological testsactivities of daily livinghealth information managementelectronic health recordsconsumer health information
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 29 , Issue 7 , August 2023 , pp. 662 - 669
Copyright
Copyright © INS. Published by Cambridge University Press, 2023

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