A Theory-Based Patient Portal eLearning Program for Older Adults With Chronic Illnesses

The use of patient portals (PP), which allow patients to access their own health records and communicate with their providers, has strong potential to assist older adults with healthcare management, especially for those with chronic illness. Despite the potential benefits, adoption rates of portal use among older adults is low, due to the lack of familiarity with the technology and awareness of PP programs or insufficient technical support. The research team implemented a vendor-agnostic adult-friendly eLearning program, called the Theory-based Patient portal eLearning Program (T-PeP), which includes guided training and instruction for PP utilization. Formative and process evaluations assessed the use of the program, along with preliminary impact.

The specific aims of this research were as follows:

• Optimize and implement T-PeP in an older adult online community, and conduct formative and process evaluations.
• Assess the impact of T-PeP on PP knowledge, selected health outcomes (health decision making self-efficacy and eHealth communication), PP self-efficacy and use, and eHealth literacy in older adults. 

Researchers optimized and implemented the 3-week T-PeP program, covering PP system navigation, functionality overview, learning modules, discussion boards, and a virtual library. A two-arm randomized controlled trial was conducted comparing a group assigned to use the T-PeP program with a control group with no intervention. Two hundred and seventy-two adults, age 50 years or older and with at least one chronic condition participated in the study. PP knowledge was assessed at baseline, 3 weeks, and 12 weeks using a questionnaire developed and tested in a prior study, focused on personal health and portal knowledge. Self-efficacy for health decision making was also assessed using the Decision Self-Efficacy Scale – which measures self-confidence in one’s ability to make decisions - to capture the person’s ability to obtain information, ask questions, and make a choice.

The study findings suggested that the T-PeP program was effective in improving older adults' knowledge and use of PPs, health decision making, and communication with their providers. Further research is need to test the program’s effects on longer-term behaviors and clinical outcomes.