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Research Letter |

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

S. Ryan Greysen, MD, MHS, MA1; Carie Chin Garcia, MD2; Rebecca L. Sudore, MD, MPH3,4; Irena Stijacic Cenzer, MA3,4; Kenneth E. Covinsky, MD, MPH3,4
[+] 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.
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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.

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Figure.
Adjusted Risk Ratios for Internet Use in 2002 and 2010 in Low-Use Groups

Relative risk of 1.0 indicates no difference in change from 2002 to 2010 compared with reference group (from left to right, vs no functional impairment [P = .08], age younger than 75 years [P = .04], white race [P = .01], good or better self-rated health [P = .02], no chronic condition [P = .86]). Risk ratios are adjusted for demographic characteristics (sex, race, marital status) and socioeconomic status (education and net worth). All analyses are weighted for differential probability of selection and the complex sampling design of the Health and Retirement Study.aStatistically significant comparison.

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