Factors Affecting Patients’ Use of Electronic Personal Health Records

England has recently introduced a nationwide electronic personal health record (ePHR) called Patient Online. Although ePHRs are widely available, adoption rates of ePHRs are usually low. Understanding the factors affecting patients’ use of ePHRs is considered important to increase adoption rates and improve the implementation success of ePHRs. Therefore, the current study aims to examine the factors that affect patients’ adoption of ePHRs in England.
A systematic review was conducted to identify factors that affect patients’ adoption of ePHRs. Then, the most common theories and models relevant to technology adoption and human behaviour were reviewed to select an appropriate theory and use it as a theoretical lens for examining the factors in the current study. The Unified Theory of Acceptance and Use of Technology (UTAUT) was selected and tailored to the context of ePHRs by including the most influential factors identified by the systematic review. A cross-sectional survey of 624 patients in four general practices in West Yorkshire was carried out to empirically examine the proposed model via structural equation modelling.
The results showed that performance expectancy, effort expectancy, and perceived privacy and security were significant predictors of behavioural intention. The relationship between social influence and behavioural intention was not statistically significant. Both facilitating conditions and behavioural intention affected use behaviour. Performance expectancy was also a significant mediator of the effect of both effort expectancy and perceived privacy and security on behavioural intention. Eleven relationships were moderated by age, sex, income, education, ethnicity, and internet access. The proposed model accounted for 76% and 48% of the variance in behavioural intention and use behaviour, respectively.
The current study makes a significant contribution by adapting and validating a theoretical model (UTAUT) in a new context (ePHRs). Further, this study contributes to practices by providing several implications for developers, marketers, and GP practices.