Attitudes and associated factors of patients’ adoption of patient accessible electronic health records in China — A mixed methods study

Abstract

Background Although patient accessible electronic health records (PAEHRs) offer great potential in enhancing the provision of patient-centered care and improving satisfaction, the adoption rate is still low. Currently, few studies are there for researchers and health organization leaders to understand patients’ thoughts and related factors of PAEHRs adoption in developing countries. China adopted more limited practices of PAEHRs, among which we selected Yuebei People's Hospital as an example. Objective The study aimed to research patient attitudes toward PAEHRs use and the associated factors of patients’ adoption of PAEHRs in China, which is achieved by both qualitative and quantitative studies. Methods This study employed sequential mixed-methods. The DeLone & McLean information systems (D&M IS) success model, Unified Theory of Acceptance and Use of Technology (UTAUT) and task-technology fit (TTF) model were used to guide the research. Finally, we collected 28 valid in-depth interview responses, 51 valid semi-structured interview responses and 235 valid questionnaire responses. The research model was tested and validated using data collected. Results The findings of the qualitative study reveal that patients’ rate perceived task productivity and customer satisfaction as benefits, and poor-quality information as flaws. Results of the quantitative study show that the drivers of behavioral intention are performance expectance, effort expectancy and social influence; the predictors of use behavior are TTF and behavioral intention. Conclusion It is necessary to consider PAEHRs’ task-tool role in patients’ adoption behavior. Hospitalized patients value PAEHRs’ practical attributes and attach much importance to the information content and application design.

From theory to practice: An integrated TTF-UTAUT study on electric vehicle adoption behavior

“…The empirical results show a significant and favourable connection between these constructs. These findings are consistent with previous research that has underlined the importance of technological and performance-related variables when it comes to integrating new technology [ 14 , 23 , 72 , 73 , 76 ]. Wan et al [ 56 ] assert that an improved impression of the utility of EVs correlates with a higher degree of technological fit.…”

“…These findings are in perfect conformity with earlier research from academic publications [ 47 , 48 , 51 , 56 , 72 ]. Liu et al [ 73 ] contended that TTF is an essential predictors of BI. In the EV context, Cruz-Jesus et al [ 41 ]) argued that TTF is an important predictor of intention then in internal combustion vehicles.…”

The Implementation of Federated Digital Identifiers in Health Care: Rapid Review

“…Similarly, the factors that influenced adoption of PAEHRs were not unique to platforms that use FDIs with a single sign-on interface and were instead common to all digital health technologies. For example, facilitators such as supportive legislation, clear government guidelines, recognized standards, and proper stakeholder engagement worked across PAEHR platforms [114][115][116][117]. Negative attitudes and beliefs about health care professionals, a lack of leadership engagement, a lack of comprehensive information, stakeholder disagreements, and the presence of multiple local initiatives were, on the other hand, common barriers across PAEHRs, irrespective of the type of identity management system used [108,117,118].…”

“…For example, an individual in Taiwan was able to share or restrict information access to specific health care providers but could not provide access to a trusted individual like a caregiver, whereas someone from Singapore was unable to restrict access to a specific provider that belongs to their care circle but was able to provide access to an individual that they trust [18,74,97,98]. This variation can also be observed in PAEHRs not managed by FDIs [111,117]. Previous work by Essen et al [10] examining policy documentation of PAEHRs around the world also highlighted a heterogenous PAEHRs landscape with distinct services, regulation approaches, and patients' access across jurisdictions.…”