JMIR Human Factors - a leading peer-reviewed ehealth journal

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Background: Most studies on the eHealth divide among older people have compared users to nonusers and found that age, gender, and education were associated with eHealth misuse. They assumed that these characteristics were structural barriers to eHealth adoption. Furthermore, eHealth practices have been examined in a narrow and incomplete way, and the studies disagree about the association between health conditions and eHealth use. Using a more dynamic theoretical lens, we investigated the potential motivations driving older adults’ agential adoption of eHealth practices despite their advanced age. Objective: This study aimed to obtain a complete and detailed description of eHealth uses among older adults; examine whether demographic characteristics such as age, gender, and education (previously related to eHealth misuse) are still associated with the various eHealth clusters; and determine whether contextual factors such as changes in the health condition of older eHealth users or their loved ones are associated with older adult eHealth use. Methods: We conducted a 30-minute telephone interview with a representative sample of 442 Israeli adults (aged ≥50 years) with a sampling error of 2.04%. The interviews were conducted in Hebrew, Arabic, and Russian. Using factor analysis with 21 eHealth use questions, we identified 4 eHealth clusters: instrumental and administrative information seeking, information sharing, seeking information from peers, and web-based self-tracking. In addition to age, gender, education, internet experience, frequency of internet use, perceived eHealth literacy, and self-rated health, we asked respondents to indicate how much they had used offline health services because of a health crisis in the past year. Results: We found differences in the number of older eHealth users in the various clusters. They used instrumental and administrative information (420/442, 95%) and obtained information from peers (348/442, 78.7%) the most; followed by web-based self-tracking related to health issues (305/442, 69%), and only a few (52/442, 11.3%) uploaded and shared health information on the web. When controlling for personal attributes, age, gender, and education were no longer predictors of eHealth use, nor was a chronic ailment. Instead, internet experience, frequency of internet use, and perceived eHealth literacy were associated with 3 eHealth clusters. Looking for health information for family and friends predicted all 4 eHealth clusters. Conclusions: Many older adults can overcome structural barriers such as age, gender, and education. The change in their or their loved ones’ circumstances encouraged them to make deliberate efforts to embrace the new practices expected from today’s patients. Seeking health information for family and friends and dealing with unexpected health crises motivates them to use eHealth. We suggest that health professionals ignore their tendency to label older people as nonusers and encourage them to benefit from using eHealth and overcome stereotypical ways of perceiving these patients.

Electronic medical record (EMR) systems possess the potential to enable smart healthcare by serving as a hub for the transformation of medical data into meaningful information, knowledge, and wisdom in the health care sector

EHealth literacy is defined as the use of emerging information and communications technology to improve or enable health and health care. The study examined whether literacy disparities are diminished or enhanced in the search for health information on the Internet. We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286). Respondents who were highly eHealth literate tended to be younger and more educated than their less eHealth-literate counterparts. They were also more active consumers of all types of information on the Internet, used more search strategies, and scrutinized information more carefully than did the less eHealth-literate respondents. Finally, respondents who were highly eHealth literate gained more positive outcomes from the information search in terms of cognitive, instrumental (self-management of health care needs, health behaviors, and better use of health insurance), and interpersonal (interacting with their physician) gains. The association of eHealth literacy with background attributes indicates that the Internet reinforces existing social differences. The more comprehensive and sophisticated use of the Internet and the subsequent increased gains among the high eHealth literate create new inequalities in the domain of digital health information. http://dx.doi.org/10.7175/rhc.v3i3.281

There seems to be an inherent tension between wiki affordances—open boundaries, unconstrained editing, and transparency—and traditional knowledge management (KM) routines used in firms. The objective of this study is to investigate how users respond to these tensions during adoption of wiki technology at the workplace. The theoretical lens of sociomateriality highlights the manner in which routines and materiality (namely, technology) relate to one another, providing a useful conceptualization for our investigation. In particular, we adopt Leonardi’s theory of human and material imbrication, which stresses the importance of a worker’s past experiences with technology in determining his future adoption decisions. Extending Leonardi’s conceptualization, we suggest that out-of-work experiences are also influential. Namely, we argue that attitudes towards Wikipedia influence one’s response to wiki deployment in the workplace. Using an online survey containing four open-ended questions, we assessed the perceptions of employees towards wiki deployment. Results from our qualitative analysis of 1032 responses reveal five approaches users take in responding to the tensions between wiki affordances and existing KM routines, highlighting the effect of users’ dispositions towards Wikipedia. Our findings inform the sociomateriality literature and shed light on the challenges faced by organizations trying to adopt social media tools.