Navigating the Digital Divide: Utilization of Patient Portals Among Older Adults During the COVID-19 Pandemic in the United States

The COVID-19 pandemic has accelerated the adoption of patient portals, which enhance patient-provider communication, streamline medical records management, and provide tailored educational materials. However, older patients face challenges in adopting these technologies, potentially exacerbating health and healthcare disparities. Guided by the Senior Technology Acceptance and Adoption Model (STAM), this study explores older adults' experiences with patient portals during the pandemic to gain an in-depth understanding of the factors influencing their adoption. We conducted semi-structured virtual interviews in 2021 with 31 older adults aged 60 or older with healthcare needs. The interviews were thematically coded and analyzed using the constant comparative method in grounded theory. The three phases of technology acceptance in STAM-objectification, incorporation, and conversion-served as sensitizing concepts in our analysis. The findings showed that some older patients felt compelled to use patient portals during the pandemic, bypassing the objectification phase, which is crucial for building an intention to use new technology. Older patients who lack a strong intention to use patient portals tended to report challenges in the incorporation phase, focusing more on the difficulties rather than the usefulness. These themes highlight obstacles to the adoption of patient portals during the conversion phase. Various suggestions for patient portal training and educational programs tailored to the needs of older adults were proposed to facilitate their adoption of patient portals. The study suggests areas for improvement to increase patient portal adoption among older patients, offering valuable insights for healthcare providers and policymakers to enhance equitable access to digital healthcare services.