Eun-Shim Nahm

Managing Chronic Conditions with E-Learning

Our Researcher: Eun-Shim Nahm, PhD, RN, FAAN

By Dan Mezibov

More than 70 million Americans aged 50-plus have at least one chronic illness requiring long-term and complex treatment. Using secure, online portals, patients and caregivers can better manage these illnesses by communicating directly with providers and by accessing lab results, medication history, and other health records at their convenience. Approximately 50 percent of U.S. hospitals and 40 percent of physicians use some form of this technology, according to Healthcare IT News.
 
But despite the potential benefits and available federal funding to help health care organizations adopt the technology, Americans’ patient portal use remains low (about 27 percent in 2014). Moreover, most older adults receive little or no training from their providers on how to use the portals, explains Eun-Shim Nahm, PhD, RN, FAAN, professor at the University of Maryland School of Nursing, director of its Nursing Informatics master’s specialty, and co-director of its Biology and Behavior Across the Lifespan organized research center. 
 
Nahm, a pioneering nurse gerontechnology researcher who was recently named a fellow of the Gerontological Society of America, has conducted several large studies funded by the National Institutes of Health to help older adults acclimate to technological innovations that allow them to participate in their care.   
 
“Patient portals can be a robust tool,” Nahm says, pointing out that they can help patients schedule appointments, request prescription refills, check immunization history, and exchange secure emails with their health care teams. But older adults “didn’t grow up with technology,” she explains, “and so they often think it’s too complicated and don’t even try. Many do not even know what a web browser is.”
 
Prior studies have shown that patient portals can have positive impacts on care, but a lack of research on portal use specifically by older adults has created a knowledge gap on how to encourage the technology’s adoption in a population often challenged by frailty and for whom learning new programs may not come naturally.
 
With federal funding from the Agency for Healthcare Research and Quality, Nahm has developed and is testing the feasibility of what she believes is the first online nationwide training program to support portal use in older adults. Her investigation involves 272 subjects who have chronic conditions such as arthritis, diabetes, hypertension, and heart disease. Using easy step-by-step instructions, video demonstrations, moderated discussion boards, and a virtual library of educational resources, the study is assessing how this e-learning impacts not only participants’ knowledge and use of patient portals, but also their health decision-making, communication with providers, and medication management.
 
Nahm’s research team will also survey the participants about what factors make working with patient portals easy or challenging. Findings from the study will provide hospitals, health providers, portal vendors, and policymakers with in-depth information on older adults’ use of patient portals and the special needs they face in the hope this population will be taken into consideration in future portal design. In the meantime, Nahm explains, research shows that users who receive sufficient training experience less frustration when trying new technologies.  
 
“Everyone gets older, and we want to enjoy our health and life. Technology can help,” Nahm says. “I feel good seeing that ‘Aha!’ moment in an older adult when the learning takes hold.”