Redesigning a telehealth diabetes management program for a digital divide seniors population

Recent advances in health information technologies promise to significantly improve the quality of care and quality of life for individuals who are chronically ill. However, significant challenges exist in targeting Digital Divide populations who are likely to be older, less educated, and novice computer users. This article presents a framework for understanding and reducing barriers for older adults to effectively use health information systems designed for disease management. The research is illustrated in the context of the IDEATel project, a large-scale telemedicine diabetes management and education program. The framework has three interdependent foci: hardware and software systems, tasks supported by the system, and user profiles. These foci are addressed in the context of usability and training studies. The studies document the challenges faced in facilitating patients' access to Web resources supporting disease management. The article discusses system design changes that are intended to increase participants' productive use of system resources.