Sociotechnical Drivers and Barriers in the Consumer Adoption of Personal Health Records: Empirical Investigation

Abstract

Background Increasingly popular in the health care domain, electronic personal health records (PHRs) have the potential to foster engagement toward improving health outcomes, achieving efficiencies in care, and reducing costs. Despite the touted benefits of PHRs, their uptake is lackluster, with low adoption rates. Objective This paper reports findings from an empirical investigation of the sociotechnical factors affecting the adoption of PHRs. Methods A research model comprising personal and technological determinants of PHR adoption was developed and validated in this study. Demographic, technographic, and psychographic data pertaining to the use of PHRs were collected through a web-based questionnaire for past, current, and potential users. Partial least squares-based structural equation modeling was used to estimate a structural model of cognitive and affective factors impacting intentions to use PHRs. Results The analysis revealed that in addition to the expected positive impact of a PHR system’s usefulness and usability, system integration also positively affects consumers’ intention to adopt. The results also suggest that higher levels of perceived usability and integration do not translate into higher levels of perceived usefulness. The study also highlights the importance of subjective norms, technology awareness, and technology anxiety as direct antecedents of the intention to adopt PHRs. The differential effects of the adoption factors are also discussed. Conclusions We hope that our study will contribute to the understanding of consumer adoption of PHRs and help improve the design and delivery of consumer-centric health care technologies. After discussing the implications for research, we provide suggestions and guidelines for PHR technology developers and constituents in the health care delivery chain.

The Use of a Technology Acceptance Model (TAM) to Predict Patients’ Usage of a Personal Health Record System: The Role of Security, Privacy, and Usability

“…The literature on PHR has indicated that adoption barriers may be linked to technology factors such as security concerns, system usability, and ineffective healthcare provider system integration [37,41,[59][60][61]. Several personal factors have also been articulated as barriers to adopting these technologies, such as lack of technology awareness, competency, chronic medical conditions, and unrealistic expectations [41,57,[61][62][63][64][65].…”

“…The reviewed relevant studies show that chronically ill or disabled patients and their caregivers and older people's caregivers have a higher likelihood of adopting and using PHR technologies [70][71][72][73]. This user group often views PHR technologies as useful in communicating with the correct personnel to obtain personalised care [37,71,74].…”

“…Several reasons have been proposed for the lag in adoption in the literature, which are often contradictory with intuition; often, the results are mixed [38,54,55]. As a result, authors have urged more studies in the consumer adoption PHR area [34,37,38,56,57].…”