If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging

Abstract

BackgroundPersonal health records (PHRs) are an important tool for empowering patients and stimulating health action. To date, the volitional adoption of publicly available PHRs by consumers has been low. This may be partly due to patient concerns about issues such as data security, accuracy of the clinical information stored in the PHR, and challenges with keeping the information updated. One potential solution to mitigate concerns about security, accuracy, and updating of information that may accelerate technology adoption is the provision of PHRs by employers where the PHR is pre-populated with patients’ health data. Increasingly, employers and payers are offering this technology to employees as a mechanism for greater patient engagement in health and well-being.ObjectiveLittle is known about the antecedents of PHR acceptance in the context of an employer sponsored PHR system. Using social cognitive theory as a lens, we theorized and empirically tested how individual factors (patient activation and provider satisfaction) and two environment factors (technology and organization) influence patient intentions to use a PHR among early adopters of the technology. In technology factors, we studied tool empowerment potential and value of tool functionality. In organization factors, we focused on communication tactics deployed by the organization during PHR rollout.MethodsWe conducted cross-sectional analysis of field data collected during the first 3 months post go-live of the deployment of a PHR with secure messaging implemented by the Air Force Medical Service at Elmendorf Air Force Base in Alaska in December 2010. A questionnaire with validated measures was designed and completed by 283 participants. The research model was estimated using moderated multiple regression.ResultsProvider satisfaction, interactions between environmental factors (communication tactics and value of the tool functionality), and interactions between patient activation and tool empowerment potential were significantly (P<.05) associated with behavioral intentions to use the PHR tool. The independent variables collectively explained 42% of the variance in behavioral intentions.ConclusionsThe study demonstrated that individual and environmental factors influence intentions to use the PHR. Patients who were more satisfied with their provider had higher use intentions. For patients who perceived the health care process management support features of the tool to be of significant value, communication tactics served to increase their use intentions. Finally, patients who believed the tool to be empowering demonstrated higher intentions to use, which were further enhanced for highly activated patients. The findings highlight the importance of communication tactics and technology characteristics and have implications for the management of PHR implementations.

The patient perspective on the use of information and communication technologies and e-health in rehabilitation

“…Although growing patient demand to online personal health record (PHR) access was already recognized in other studies [25,[31][32][33], it is still not widely adopted. A study among 283 individuals over the age of 18 found that individual factors (satisfaction with provider, belief of the tool to be empowering) and environmental factors (communication tactics, technology characteristics and management support) influence intentions to use a PHR [34]. These aspects should be taken into account with the implementation of PHRs.…”

Engaging Primary Care Patients to Use a Patient-Centered Personal Health Record

“…Patients with chronic conditions have more office visits, laboratory and procedural tests, and selfmanagement needs. 40,41 Although critics express concerns that online technologies might discriminate against older patients, 42,43 1 out of 3 patients aged 60 to 69 years enrolled, the highest use rate by any age-group.…”

“…Patients with chronic conditions have more office visits, laboratory and procedural tests, and selfmanagement needs. 40,41 Although critics express concerns that online technologies might discriminate against older patients, 42,43 1 out of 3 patients aged 60 to 69 years enrolled, the highest use rate by any age-group.Black and Hispanic patients were less likely to use the IPHR. Even though prior studies document a digital divide in use of personal health records among at-risk populations, 44 the growing ubiquity of mobile devices is closing the digital divide, 45 and greater use of these very technologies is being discussed to narrow health inequities.…”

Analysis of College Students� Personal Health Information Activities: Online Survey (Preprint)

“…that is associated with multiple interactions among varying users (e.g., patients, providers, insurance companies), complex health information and systems (e.g., labs, medications, insurance), and advanced health information technology tools (e.g., personal health records, personal health devices) [2][3][4]. In PHIM research, little is known about college students' information management activities in the health context.…”

“…records, to fulfill their health information needs [2][3]. For a narrower scope of personal health documents, trained hospital records managers in direct patient care or billing have conventionally performed some of these activities.…”