Around two months ago a new journal paper was published where I was one of the co-authors. The paper belongs to the quite large set of papers that are based on the national patient survey that I have been referring to multiple times in this blog. The title of this new paper is “Technological and informational frames: explaining age-related variation in the use of patient accessible electronic health records as technology and information” and it was published in the journal Information Technology & People.

In this paper we are comparing responses from the different age-groups Young (< 51 years), Older adults (51-66 years) and Elderly (>66 years), to investigate how the preference and use of patient accessible electronic health records (PAEHRs) and PAEHR information differ between them. We are also bringing in the theory of technological frames for the analysis. My DOME consortium colleague Isto Huvila is the main author and the other co-authors are Åsa Cajander, Heidi Enwald, Kristina Eriksson-Backa and Hanife Rexhepi.

The paper was published Open Access and you can find it here. You can find the abstract below. To recap, these are the national survey articles published prior to this one (follow the links to reach the Open Access articles):

• Moll, J., and Rexhepi, H. (2020). The Effect of Patient Accessible Electronic Health Records on Communication and Involvement in Care-A National Patient Survey in Sweden. Studies in Health Technology and Informatics (Vol. 270). pp. 1056-1060.
• Nurgalieva, L., Cajander, Å., Moll, J., Åhlfeldt, R-M., Huvila, I., and Marchese, M. (2020). ‘I do not share it with others. No, it’s for me, it’s my care’: On sharing of patient accessible electronic health records. Health Informatics Journal. DOI: 10.1177/1460458220912559.
• Rexhepi, H., Moll, J., and Huvila, I. (2020). Online electronic healthcare records: Comparing the views of cancer patients and others. Health Informatics Journal. DOI: 1460458220944727.
• Rexhepi, H., Moll, J., Huvila, I., and Åhlfeldt, RM. (2020). Do you want to receive bad news through your patient accessible electronic health record? A national survey on receiving bad news in an era of digital health. Proceedings of the Eighteenth International Symposium for Health Information Management Research (Kalmar, Sweden, September 17-18). pp. 169-178.
• Huvila, I., Moll, J., Enwald, H., Hirvonen, N., Åhlfeldt, R-M., and Cajander, Å. (2018). Age-related differences in seeking clarification to understand medical record information. Proceedings of the 12th ISIC conference, published in Information Research (Vol 22, No 4).
• Hägglund, M., Moll, J., Åhlfeldt, R-M., and Scandurra, I. (2018). Timing it right – patients’ online access to their record notes in Sweden. Studies in Health Technology and Informatics (Vol. 247). pp. 336-340.
• Moll, J., Rexhepi, H., Cajander, Å., Grünloh, C., Huvila, I., Hägglund, M., Myreteg, G., Scandurra, I., and Åhlfeldt, R-M. (2018). Patients’ Experiences of Accessing Their Electronic Health Records: National Patient Survey in Sweden. Journal of Medical Internet Research (Vol 20, No 11). e278.

And, last, here is the abstract from the most recently published article:

Purpose – Data from a national patient survey (N 5 1,155) of the Swedish PAEHR “Journalen” users were analysed, and an extended version of the theory of technological frames was developed to explain the variation in the technological and informational framing of information technologies found in the data.

Design/methodology/approach – Patient Accessible Electronic Health Records (PAEHRs) are implemented globally to address challenges with an ageing population. However, firstly, little is known about age-related variation in PAEHR use, and secondly, user perceptions of the PAEHR technology and the health record information and how the technology and information–related perceptions are linked to each other. The purpose of this study is to investigate these two under-studied aspects of PAEHRs and propose a framework based on the theory of technological frames to support studying the second aspect, i.e. the interplay of information and technology–related perceptions.

Findings – The results suggest that younger respondents were more likely to be interested in PAEHR contents for general interest. However, they did not value online access to the information as high as older ones. Older respondents were instead inclined to use medical records information to understand their health condition, prepare for visits, become involved in their own healthcare and think that technology has a much potential. Moreover, the oldest respondents were more likely to consider the information in PAEHRs useful and aimed for them but to experience the technology as inherently difficult to use.

Research limitations/implications – The sample excludes non-users and is not a representative sample of the population of Sweden. However, although the data contain an unknown bias, there are no specific reasons to believe that it would differently affect the survey’s age groups.

Practical implications – Age should be taken into account as a key factor that influences perceptions of the usefulness of PAEHRs. It is also crucial to consider separately patients’ views of PAEHRs as a technology and of the information contained in the EHR when developing and evaluating existing and future systems and information provision for patients.

Social implications – This study contributes to bridging the gap between information behaviour and systems design research by showing how the theory of technological frames complemented with parallel informational frames to provide a potentially powerful framework for elucidating distinct conceptualisations of (information) technologies and the information they mediate. The empirical findings show how information and information technology needs relating to PAEHRs vary according to age. In contrast to the assumptions  inmuch of the earlier work, they need to be addressed separately.

Originality/value – Few earlier studies focus on (1) age-related variation in PAEHR use and (2) user perceptions of the PAEHR technology and the health record information and how the technology and information–related perceptions are linked to each other.