Abstract:

The electronic Personal Health Record (PHR) is a patient-centric information management tool which allows the patient to maintain their own digital records with medical diagnoses, medication plans, vaccination, and other patient-related data. While the introduction of PHR aims to make processes in healthcare more efficient and transparent, there are still barriers to the adoption of PHR including concerns about privacy, security and use of the technology. An adequate use of the PHR requires a set of competencies from the general use of digital technologies to the management of digital medical records according to regulations in a national healthcare system. Specific user groups, including less digitally competent populations such as older adults, need specific support in learning how to use PHR and managing their own medical records.

This paper presents the design of e-learning activities for senior learners as part of an e-learning application developed in the ePA-Coach project founded by the German Ministry of Research and Education. The design of the e-learning activities aims to support senior learners in acquiring competencies needed for a self-determined use of PHP in the context of the German healthcare system. The design of the e-learning activities is based on the core drive analysis using the Octalysis gamification framework. The Octalysis framework is used to support designers in creating engaging experiences by focusing on the eight core drives for human motivation. The ePA-Coach e-learning application aims to support older adults in learning how to operate their own PHR in a self-determined way by providing an engaging learning experience based on the eight motivational drives specified in the Octalysis framework. The design of the e-learning activities in ePA-Coach utilizes a range of gamification techniques proposed in the Octalysis framework, such as progress, levels, tasks, instant feedback, unlocking milestones, and mentorship.

The paper presents the initial and the new design of learning activities based on the evaluation results from a study with 78 adults, from 65 to 93 years old. The paper describes how the initial design of the e-learning activities was derived from the Octalysis framework and how it was further adapted based on the evaluation results. The evaluation results showed that some core drives and gamification elements derived from the Octalysis framework were poorly rated by the users in this age group. This included poor ratings for the proposed narrative design and embedding e-learning in story-telling, which is related to the core drive Epic Meaning & Calling. At the same time, the target users expressed a strong preference for the core drive Empowerment of Creativity & Feedback, which led to a number of additions to the design with focus on an enhanced choice perception related to the choice of alternative e-learning activities. The paper describes these and other design decisions in more detail focusing on which core drives from the Octalysis framework had to be scaled back while others had to be scaled up and how these changes led to redesigning e-learning activities in the ePA-Coach e-learning application.

Keywords:

Personal Health Record (PHR), e-learning, senior learners, gamification, Octalysis.