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

BACKGROUND: Personal 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 th...

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Detalles Bibliográficos
Autores principales: Agarwal, Ritu, Anderson, Catherine, Zarate, Jesus, Ward, Claudine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Gunther Eysenbach 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636193/
https://www.ncbi.nlm.nih.gov/pubmed/23470453
http://dx.doi.org/10.2196/jmir.2243
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author Agarwal, Ritu
Anderson, Catherine
Zarate, Jesus
Ward, Claudine
author_facet Agarwal, Ritu
Anderson, Catherine
Zarate, Jesus
Ward, Claudine
author_sort Agarwal, Ritu
collection PubMed
description BACKGROUND: Personal 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. OBJECTIVE: Little 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. METHODS: We 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. RESULTS: Provider 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. CONCLUSIONS: The 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.
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spelling pubmed-36361932013-04-26 If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging Agarwal, Ritu Anderson, Catherine Zarate, Jesus Ward, Claudine J Med Internet Res Original Paper BACKGROUND: Personal 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. OBJECTIVE: Little 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. METHODS: We 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. RESULTS: Provider 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. CONCLUSIONS: The 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. Gunther Eysenbach 2013-02-26 /pmc/articles/PMC3636193/ /pubmed/23470453 http://dx.doi.org/10.2196/jmir.2243 Text en ©Ritu Agarwal, Catherine Anderson, Jesus Zarate, Claudine Ward. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.02.2013. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Agarwal, Ritu
Anderson, Catherine
Zarate, Jesus
Ward, Claudine
If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging
title If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging
title_full If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging
title_fullStr If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging
title_full_unstemmed If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging
title_short If We Offer it, Will They Accept? Factors Affecting Patient Use Intentions of Personal Health Records and Secure Messaging
title_sort if we offer it, will they accept? factors affecting patient use intentions of personal health records and secure messaging
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636193/
https://www.ncbi.nlm.nih.gov/pubmed/23470453
http://dx.doi.org/10.2196/jmir.2243
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