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The American Journal of Managed Care Special Issue: Health Information Technology - Guest Editor: Farzad Mostashari, MD, ScM
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Older Adult Consumers' Attitudes and Preferences on Electronic Patient-Physician Messaging
Richard Lam, MD, MBA; Victor S. Lin BS; Wendy S. Senelick, MPH; Hong-Phuc Tran, MD; Alison A. Moore, MD, MPH; and Brandon Koretz, MD, MBA

Older Adult Consumers' Attitudes and Preferences on Electronic Patient-Physician Messaging

Richard Lam, MD, MBA; Victor S. Lin BS; Wendy S. Senelick, MPH; Hong-Phuc Tran, MD; Alison A. Moore, MD, MPH; and Brandon Koretz, MD, MBA
A randomized controlled trial was conducted to assess whether adding a peer testimonial to a mailing increases conversion rates from brand name prescription medications to lower-cost equivalents.
Overall, attitudes of the older adult patients about electronic communication were generally positive. Factors associated with positive attitudes included: physician/staff encouragement, improved patient education, a user-friendly program, and increased features and functionality. These suggestions can provide a guide for developers and implementers of future patient web portal systems. Results from respondents who never used the messaging system highlight the need for effective educational material and physician engagement.

Limitations and Future Research

Results of this study should be interpreted with care. The sample surveyed was limited to those who had e-mail and signed up for the messaging service, and surveys were returned by 12% of the patients to whom the e-mails successfully delivered. Therefore our findings may not represent attitudes and  preferences of general patient populations. Future research with larger samples and with more outreach to those who are less computer savvy, as well as qualitative research with small groups of various patient populations, would provide greater insight regarding how to develop and employ patient and provider messaging systems.


This study suggests that the younger and older adult patients with some experience with electronic communication will embrace electronic communication for healthcare information. Although a majority of older adult patients have positive attitudes toward health information exchange, electronic communication platforms must address key issues in consumer education/training, physician commitment to use electronic messaging with their patients, and adoption of an accessible interface to ensure productive older adult consumer participation. Successful patient and physician engagement may have implications in patient empowerment and positive health outcomes.

Author Affiliations: From David Geffen School of Medicine at UCLA (RL, VSL, WSS, H-PT, AAM, BK), Department of Medicine, Division of Geriatrics, UCLA Health System, Los Angeles, CA.

Funding Source: None.

Author Disclosures: The authors (RL, VSL, WSS, H-PT, AAM, BK) report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (RL, WSS, BK); acquisition of data (RL, VSL, WSS); analysis and interpretation of data (RL, VSL, WSS, H-PT, AAM); drafting of the manuscript (RL, WSS, H-PT, AAM); critical revision of the manuscript for important intellectual content (RL, VSL, WSS, H-PT, AAM); statistical analysis (VSL); administrative, technical, or logistic support (VSL, WSS, BK); and supervision (WSS).

Address correspondence to: Richard Lam, MD, MBA, David Geffen School of Medicine at UCLA, Department of Medicine, Division of Geriatrics, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095. E-mail:
1. Centers for Medicare & Medicaid Services.

2. Chaudhry B, Wang J, Wu S, et al. Systemic review: impact of health information technology on quality efficiency, and costs of medical care. Ann Intern Med. 2006;144:742-752.

3. Shekelle PG, Morton SC, Keeler EB. Costs and benefits of health information technology. Evid Rep Technol Assess (Full Report). 2006:1-71.

4. Administration on Aging; US Department of Health and Human Services. A Profile of Older Americans: 2012.
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