Looking at how young people use the Web for virtually everything from commerce to social networking, it’s not hard to imagine an increasingly virtual future health care world. If Don Berwick is right that at least half of current in-person clinical encounters don’t require a visit, this generation likely will change the character of US health care delivery.

But what about the other end of the chronological spectrum? One of the common questions I get is how we make information therapy (Ix) relevant for seniors–the population that consumes the greatest amount of health care.

Although part of the answer is that Ix need not be delivered electronically, the more compelling notion from my perspective is that we have a magnificent and mostly untapped opportunity to extend patient-centered health information technology (HIT) applications to people who really need them.

The potential of the innovative applications that comprise patient-centered HIT (e.g., personal health records (PHRs), secure messaging, online tools, etc.) can be maximized if we successfully integrate them into patient-clinician relationships. Ideally, they should be viewed as tools within that context.

More than anybody else, seniors are likely to have ongoing and frequent relationships with their clinicians. In fact, in many cases, seniors concurrently interact with multiple providers, making the need for coordinated relationship management tools all the more important. Without them, we wind up with considerable redundancy, poor communication (not just between patient and doctor but among providers involved in that person’s care), and the possibility for dangerous medical errors.

Furthermore, other characteristics more common as people age (e.g., limited mobility, cognitive functioning issues) increase the importance of having patient-centered HIT applications. They can allow for communication without patient and clinician needing to be in the same place and for communication to be trianglulated–for example, to include the child or spouse of a senior with cognitive impairment.

Many seniors are already accessing considerable health care information online (to some, a surprising percentage), and there’s no doubt that the aging baby boomer population will vastly expand the online senior population in the near future. However, there’s no reason why we can’t do more to help more seniors capitalize on this golden opportunity now.

Community efforts involving librarians, hospital community outreach staff, senior centers, and others can effectively break down barriers limiting seniors’ adoption of e-health resources. Although I haven’t seen a lot of empirical data, anecdotal evidence suggests that, once obstacles are removed, seniors become active Internet users.

Who do you think the next generation of PHR users will be?

–Josh

(Visit www.ixcenter.org for more about PHRs and related issues.)