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J Med Internet Res. 2019 Apr 8;21(4):e11604. doi: 10.2196/11604.

Using the Technology Acceptance Model to Explore User Experience, Intent to Use, and Use Behavior of a Patient Portal Among Older Adults With Multiple Chronic Conditions: Descriptive Qualitative Study.

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Division of General Internal Medicine, School of Medicine, University of Colorado, Aurora, CO, United States.
Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, United States.
Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United States.
mHealth Impact Lab, Colorado School of Public Health, University of Colorado, Aurora, CO, United States.
Department of Medicine, Eastern Colorado Health Care System, Department of Veterans Affairs, Denver, CO, United States.
Division of Geriatrics, Weill Cornell Medicine, New York, NY, United States.
Center for Research and Education on Aging and Technology Enhancement, University of Miami, Miami, FL, United States.



Patient portals offer modern digital tools for older adults with multiple chronic conditions (MCC) to engage in their health management. However, there are barriers to portal adoption among older adults. Understanding portal user interface and user experience (UI and UX) preferences of older adults with MCC may improve the accessibility, acceptability, and adoption of patient portals.


The aim of this study was to use the Technology Acceptance Model (TAM) as a framework for qualitatively describing the UI and UX, intent to use, and use behaviors among older patients with MCC.


We carried out a qualitative descriptive study of Kaiser Permanente Colorado's established patient portal, My Health Manager. Older patients (N=24; mean 78.41 (SD 5.4) years) with MCC participated in focus groups. Stratified random sampling was used to maximize age and experience with the portal among participants. The semistructured focus groups used a combination of discussion and think-aloud strategies. A total of 2 coders led the theoretically driven analysis based on the TAM to determine themes related to use behavior, portal usefulness and ease of use, and intent to use.


Portal users commonly used email, pharmacy, and lab results sections of the portal. Although, generally, the portal was seen to be easy to use, simple, and quick, challenges related to log-ins, UI design (color and font), and specific features were identified. Such challenges inhibited participants' intent to use the portal entirely or specific features. Participants indicated that the portal improved patient-provider communication, saved time and money, and provided relevant health information. Participants intended to use features that were beneficial to their health management and easy to use.


Older adults are interested in using patient portals and are already taking advantage of the features available to them. We have the opportunity to better engage older adults in portal use but need to pay close attention to key considerations promoting usefulness and ease of use.


aging; health information technology; multiple chronic conditions; patient portals; personal health record

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