Sustaining Patient Portal Continuous Use Intention and Enhancing Deep Structure Usage: Cognitive Dissonance Effects of Health Professional Encouragement and Security Concerns

Abstract

Sustaining patient portal use is a major problem for many healthcare organizations and providers. If this problem can be successfully addressed, it could have a positive impact on various stakeholders. Through the lens of cognitive dissonance theory, this study investigates the role of health professional encouragement as well as patients’ security concerns in influencing continuous use intention and deep structure usage among users of a patient portal. The analysis of data collected from 177 patients at a major medical center in the Midwestern region of the United States shows that health professional encouragement helps increase the continuous use intention and deep structure usage of the patient portal, while security concerns impede them. Interestingly, health professional encouragement not only has a direct positive influence on continuous use intention and deep structure usage but also lowers the negative impact of security concerns on them. The research model explains a substantial variance in continuous use intention (i.e., 40%) and deep structure usage (i.e., 32%). The paper provides theoretical implications as well as practical implications to healthcare managers and providers to improve patient portal deep structure usage and sustained use for user retention.

Trends in telehealth use among a cohort of rural patients during the COVID-19 pandemic

“… 1 , 11 Researchers have recognized numerous barriers to sustained digital health technology expansion beyond the social determinants of health. Barriers identified include design elements of the technology not being appropriate for all users, 33 privacy and safety concerns, 3 , 34 the ever-changing payment parity and reimbursement landscape for digital health technology services, 35 , 36 and the overall sentiment among both clinicians and patients that “telemedicine's benefits [are] hindered by the potential for missing information and decreased human connection between patients and providers during a telemedicine visit.” 36 (p.12)…”

Adult Patients’ Experiences of Using a Patient Portal With a Focus on Perceived Benefits and Difficulties, and Perceptions on Privacy and Security: Qualitative Descriptive Study

“…However, about 22% of our participants did not think much about this matter, stating that nothing is completely safe on the internet. This rather fatalistic view seems similar to the fact that many people are aware of the potential risk of electronic financial transactions, yet accept the risk and use digital banking [ 32 ]. Health care institutions and software companies implementing patient portals should continuously monitor the privacy and security safeguards of patient portals and provide relevant information assurance when necessary.…”

Assessing patient readiness for a patient portal implementation in the UAE

“…Tethered ePHRs provide patients with full online access to their health-care provider’s EHR (administered by health-care organizations) (Moqbel et al , 2021). In addition, tethered ePHRs do not permit the direct control of health information by patients, and there is a lack of interoperability of health information (Elsafty et al , 2020; Moqbel et al , 2021; Ruhi and Chugh, 2021).…”

“…The literature highlights the many benefits to patients who access their health information via such portals, including time and cost savings and fewer communication errors, by allowing patients to follow-up, especially when they need further explanation about their health status (Beal et al , 2021; Moqbel et al , 2021; Nambisan, 2017; Shah et al , 2015). In one study, patients who used a portal to access their health information experienced “a significant decrease in office visit rates, an increase in the use of messaging systems instead of the telephone, better medication management and better adherence to treatment protocols” compared with those who did not use a portal (Nambisan, 2017, p. 63).…”

“…These authors stressed the importance of considering low trust and high risk as new success factors for the adoption of PHR applications, both stand-alone and tethered. Those studies and others have focused on several factors that could have an impact on patients’ use of patient portals and their attitudes toward adopting them (Huvila et al , 2021; Moqbel et al , 2021; Nambisan, 2017).…”