Background Health care technologies can help improve workers’ health and productivity by supporting workplace health promotion. A personal health record app is used to manage medical data such as results from medical checkups, which facilitates decision making for medical personnel. However, an analysis of users’ technology acceptance is required to provide appropriate services based on personal health record apps. Objective The purpose of this study was to analyze the factors influencing the behavioral intention of health experts and workers to use an app in workers’ health centers and to examine differences in their perception of the main variables. Methods The study involved health experts and workers who visited 21 workers’ health centers in Korea to verify a research model in which perceived risk was added to the unified theory of acceptance and use of technology, a representative theory of information technology acceptance. After receiving ethical approval from the Korea National Institute for Bioethics Policy, 1050 questionnaires were distributed over 7 weeks with cooperation of the Korea Occupational Safety and Health Agency. A multiple linear regression analysis and multigroup path analysis were performed to verify the hypotheses, and independent samples t tests were performed to analyze differences between workers’ and health experts’ perception of the main variables. Results The analysis included data from 866 respondents (687 workers and 179 health experts). Effort expectancy (beta=.08, P=.03), social influence (beta=.43, P<.001), performance expectancy (beta=.07, P=.008), and facilitating conditions (beta=.13, P<.001) exerted significant positive effects on behavioral intention, whereas perceived risk (beta=–.29, P<.001) exerted a significant negative effect on behavioral intention. Performance expectancy had a significant effect on path differences depending on gender (critical ratio=–3.38) and age (critical ratio=1.97). Workers’ mean scores for the main variables were higher relative to those of health experts for all remaining variables except perceived risk, and significant differences were observed for all remaining variables except facilitating condition. Conclusions Social influence exerted the strongest effect on behavioral intention to use the personal health record app. Consequently, it is necessary to coordinate health promotion activities in the workplace as well as the operational direction of community institutions such as in workers’ health centers to allow workers to manage their own health via continuous use of the app. In addition, the app should be developed based on a requirement analysis of the balance between both interest groups in consideration of differences in perspective between consumers and service providers.

Worker health centers and health zones provide occupational healthcare services to workers in underserved areas of industrial health. Health zones cannot counsel workers on occupational disease prevention; worker health center personnel have to provide such services through in-person visits. Video teleconsultation can increase the accessibility of high-quality services to workers who visit health zones and improve professional personnel's efficiency. This study aimed to develop a system and an infrastructure that could facilitate video teleconsultation services between worker health centers and health zones, and analyze the services' operation status. A video teleconsultation process based on the role of local and remote institutions was designed. Based on the designed services, a web system supporting teleconsultation and an integrated gateway guaranteeing the interface with medical equipment in the web environment was developed. After analyzing the working environment, an infrastructure consisting of networks, video equipment, medical equipment, and servers necessary for teleconsultation was designed. Statistical results from the developed system and a satisfaction survey conducted by the Korea Occupational Safety and Health Agency were used to analyze the video teleconsultation services' operation status. A system, gateway, and hardware infrastructure within 21 worker health centers and 21 health zones has been operating this service since January 1, 2018. Over two years, the total number of teleconsultation service users was 4979, and the total number of questionnaire respondents was 1270. The total number of service activities was 6388 and total satisfaction was rated as 4.58 (± 0.59) out of 5. In this study, video teleconsultation services were evaluated as being very satisfactory. In particular, service accessibility and local medical personnel service were rated highly, demonstrating that the developed system and infrastructure were well designed according to the goals of the project. Keywords Video Teleconsultation system. Underserved area. Integrated gateway. Worker health center. Health zone This article is part of the topical collection on Patient Facing Systems

Background Personal health record (PHR) technology can be used to support workplace health promotion, and prevent social and economic losses related to workers’ health management. PHR services can not only ensure interoperability, security, privacy, and data quality, but also consider the user’s perspective in their design. Objective Using Fast Healthcare Interoperability Resources (FHIR) and national health care data sets, this study aimed to design and develop an app for providing worker-centered, interconnected PHR services. Methods This study considered the user’s perspective, using the human-centered design (HCD) methodology, to develop a PHR app suitable for occupational health. We developed a prototype after analyzing quantitative and qualitative data collected from workers and a health care professional group, after which we performed a usability evaluation. We structured workers’ PHR items based on the analyzed data, and ensured structural and semantic interoperability using FHIR, Systematized Nomenclature of Medicine–Clinical Terms (SNOMED-CT), and Logical Observation Identifiers Names and Codes (LOINC). This study integrated workers’ health information scattered across different Korean institutions through an interface method, and workers’ PHRs were managed through a cloud server, using Azure API for FHIR. Results In total, 562 workers from industrial parks participated in the quantitative study. The preferred data items for PHR were medication, number of steps walked, diet, blood pressure, weight, and blood glucose. The preferred features were ability to access medical checkup results, health information content provision, consultation record inquiry, and teleconsultation. The worker-centered PHR app collected data on, among others, life logs, vital signs, and medical checkup results; offered health care services such as reservation and teleconsultation; and provided occupational safety and health information through material safety data sheet search and health questionnaires. The app reflected improvements in user convenience and app usability proposed by 19 participants (7 health care professionals and 12 end users) in the usability evaluation. The After-Scenario Questionnaire (ASQ) was evaluated with a mean score of 5.90 (SD 0.34) out of 7, and the System Usability Scale (SUS) was evaluated a mean score of 88.7 (SD 4.83) out of 100. Conclusions The worker-centered PHR app integrates workers’ health information from different institutions and provides a variety of health care services from linked institutions through workers’ shared PHR. This app is expected to increase workers’ autonomy over their health information and support medical personnel’s decision making regarding workers’ health in the workplace. Particularly, the app will provide solutions for current major PHR challenges, and its design, which considers the user’s perspective, satisfies the prerequisites for its utilization in occupational health.

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BACKGROUND Health care technologies can help improve workers’ health and productivity by supporting workplace health promotion. A personal health record app is used to manage medical data such as results from medical checkups, which facilitates decision making for medical personnel. However, an analysis of users’ technology acceptance is required to provide appropriate services based on personal health record apps. OBJECTIVE The purpose of this study was to analyze the factors influencing the behavioral intention of health experts and workers to use an app in workers’ health centers and to examine differences in their perception of the main variables. METHODS The study involved health experts and workers who visited 21 workers’ health centers in Korea to verify a research model in which perceived risk was added to the unified theory of acceptance and use of technology, a representative theory of information technology acceptance. After receiving ethical approval from the Korea National Institute for Bioethics Policy, 1050 questionnaires were distributed over 7 weeks with cooperation of the Korea Occupational Safety and Health Agency. A multiple linear regression analysis and multigroup path analysis were performed to verify the hypotheses, and independent samples t tests were performed to analyze differences between workers’ and health experts’ perception of the main variables. RESULTS The analysis included data from 866 respondents (687 workers and 179 health experts). Effort expectancy (beta=.08, <i>P</i>=.03), social influence (beta=.43, <i>P</i>&lt;.001), performance expectancy (beta=.07, <i>P</i>=.008), and facilitating conditions (beta=.13, <i>P</i>&lt;.001) exerted significant positive effects on behavioral intention, whereas perceived risk (beta=–.29, <i>P</i>&lt;.001) exerted a significant negative effect on behavioral intention. Performance expectancy had a significant effect on path differences depending on gender (critical ratio=–3.38) and age (critical ratio=1.97). Workers’ mean scores for the main variables were higher relative to those of health experts for all remaining variables except perceived risk, and significant differences were observed for all remaining variables except facilitating condition. CONCLUSIONS Social influence exerted the strongest effect on behavioral intention to use the personal health record app. Consequently, it is necessary to coordinate health promotion activities in the workplace as well as the operational direction of community institutions such as in workers’ health centers to allow workers to manage their own health via continuous use of the app. In addition, the app should be developed based on a requirement analysis of the balance between both interest groups in consideration of differences in perspective between consumers and service providers.

BACKGROUND Personal Health Record (PHR) is a healthcare technology that can be used to support workplace health promotion, and prevent social and economic losses related to workers’ health management. PHR services can not only ensure interoperability, security, privacy, and data quality, but also consider the user's perspective in their design. OBJECTIVE This study aimed to design and develop a PHR app using Fast Healthcare Interoperability Resources (FHIR) and national healthcare datasets to provide worker-centered, interconnected PHR services. METHODS This study considered the user's perspective using the Human-Centered Design (HCD) methodology to develop a PHR app suitable for occupational health. A prototype was developed by analyzing quantitative and qualitative data collected from workers and an expert group, following which a usability evaluation was performed. We structured the workers’ PHR items based on the analyzed data and then ensured structural and semantic interoperability using FHIR, Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), and logical observation identifiers names and codes (LOINC). This study integrated workers’ health information that was scattered across different Korean institutions through a linkage method, and workers’ PHRs were managed through a cloud server using Azure API for FHIR. RESULTS In total, 562 workers participated in the quantitative study. The preferred data items for the PHR were medication, number of steps walked, diet, blood pressure, weight, and blood glucose. The preferred functions were accessing medical checkup results, content provision for health information, consultation record inquiry, and teleconsultation. The worker-centered PHR app collected data on topics such as life-logs, vital signs, and medical checkup results; offered healthcare services such as reservation and teleconsultation; and provided occupational safety and health information through material safety data sheet search and health questionnaires. The app reflected the improvements regarding user convenience and app usability that were proposed by 19 participants (7 experts and 12 end-users) who partook in the usability evaluation. The After Scenario Questionnaire (ASQ) was evaluated at 5.90 (± 0.34) out of 7, and the System Usability Scale (SUS) was evaluated at 88.7 (± 4.83) out of 100. CONCLUSIONS The worker-centered PHR app integrates workers’ health information that is scattered across different institutions, providing a variety of healthcare services from linked institutions through workers’ shared PHR. This app is expected to allow workers to have autonomy over their health information and support medical personnel’s decision making regarding workers’ health in the workplace. Particularly, the PHR app we developed would provide solutions for the major challenges of PHR, and its design, which would consider the user's perspective, thereby satisfying the prerequisites for its utilization in occupational health.

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