Using the PHR. In order to entice older individuals to use PHRs, the tool must be designed to accommodate their needs. For this evaluation, usability is defined as a quality attribute that assesses how easy user interfaces are to use, and also refers to the methods for improving ease-of-use during the design process. Understanding beneficiaries’ experiences in utilizing MyPHRSC and identifying what beneficiaries appreciate in the PHR sheds light onto the factors that must be taken into account in developing a tool that is valuable to the population. Most beneficiaries agreed that the PHR was easy to use once they were able to log in. However, beneficiaries gave many suggestions for improving the tool and making it more accessible for them. Overall, beneficiaries would have liked the text in the log-in screen to have a larger font and for the log-in text boxes to be located more centrally on the page. Additionally, participants in beneficiary discussion groups stated that having the ability to change the font size within the PHR helped make the PHR easier for them to read.
However, beneficiaries reported having some difficult with data entry, particularly with the Medications page of the PHR. The user observations study revealed that the confusion centered on figuring out how to enter the information, search for a drug they may be taking, select the route, and identify refills. User observations also suggested that the language used throughout the PHR was sometimes too technical for the beneficiaries to understand. Beneficiaries sometimes blamed themselves for not being able to easily navigate the system and viewed difficulties using the tool as their own misjudgment.
Although they were impressed by the extensive information in the Health Record Summary, beneficiaries in user observations were overwhelmed by the large list of illnesses and conditions and also some incorrect information on the page. The page also included information, such as medical terms, that were too technical for beneficiaries to understand. The environmental scan showed that, according to the results of the 2003 National Assessment of Adult Literacy, many individuals have difficulty reading and comprehending health information and that adults age 65 and older have lower average health literacy levels than adults in younger age groups. It is therefore necessary to present health information in a manner that is easily understandable to users.
Additionally, user observations studies indicated that beneficiaries were using the PHR but that they were not aware of all the functions offered by the PHR. Beneficiaries also favored the inclusion of certain types of additional data into the PHR.