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

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.