Functional Impairment and Internet Use Among Older Adults: Implications for Meaningful Use of Patient Portals | Electronic Health Records | JAMA Internal Medicine | JAMA Network
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Research Letter
July 2014

Functional Impairment and Internet Use Among Older Adults: Implications for Meaningful Use of Patient Portals

Author Affiliations
  • 1Division of Hospital Medicine, University of California, San Francisco
  • 2Department of Medicine, California Pacific Medical Center, San Francisco
  • 3San Francisco Veterans Affairs Medical Center, San Francisco, California
  • 4Division of Geriatric Medicine, University of California, San Francisco
JAMA Intern Med. 2014;174(7):1188-1190. doi:10.1001/jamainternmed.2014.1864

Medicare is currently dispensing $30 billion in incentives to health care facilities that adopt the use of electronic medical records (EMRs). In 2014, incentives for “meaningful use” of EMRs will require online access by patients, and reimbursement penalties of up to 5% for nonadoption will begin in 2015.1 Broader use of online patient portals to EMRs is intended to improve care coordination; yet the impact of common problems in Medicare-eligible patients, such as chronic illness or functional impairment, on Internet use is unknown.

This study was approved by the institutional review board for the University of California, San Francisco. We used the Health and Retirement Study (http://hrsonline.isr.umich.edu), a nationally representative sample of community-dwelling seniors (limited to Medicare-eligible individuals aged ≥65 years, excluding the 3%-6% of all Medicare patients who live in nursing homes), for cross-sectional analysis of Internet use at 2 time points, 2002 and 2010 (Table). Information regarding informed consent is available at the Health and Retirement Study website. We performed descriptive statistics (χ2 or t test) and multivariable regression analysis (modified Poisson) to characterize features of Internet use at each time point.

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