If we offer it, will they accept? Factors affecting patient use intentions of personal health records and secure messaging.
If we offer it, will they accept? Factors affecting patient use intentions of personal health records and secure messaging.
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DOI：
10.2196/jmir.2243
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发表时间：
2013-02-26
影响因子：
7.4
通讯作者：
Ward C
中科院分区：
文献类型：
--
作者：
Agarwal R;Anderson C;Zarate J;Ward C
个人健康记录（PHRs）是增强患者权能和促进卫生行动的重要工具。到目前为止，消费者自愿采用公开可获得的phrr的比例一直很低。这可能部分是由于患者担心数据安全性、PHR中存储的临床信息的准确性以及保持信息更新的挑战等问题。减轻对信息安全性、准确性和更新（可能加速技术采用）的担忧的一个潜在解决方案是由雇主提供PHR，其中PHR预先填充了患者的健康数据。越来越多的雇主和付款人向员工提供这种技术，作为一种机制，使患者更多地参与健康和福祉。在雇主赞助的PHR系统的背景下，对PHR接受的前因知之甚少。以社会认知理论为视角，我们对个体因素（患者激活和提供者满意度）和两个环境因素（技术和组织）如何影响早期技术采用者使用PHR的意愿进行了理论化和实证检验。在技术因素方面，我们研究了工具授权的潜力和工具功能的价值。在组织因素中，我们关注组织在PHR推出期间部署的沟通策略。2010年12月，在阿拉斯加州埃尔门多夫空军基地，空军医疗服务处部署了带有安全消息传递的PHR，我们对部署后的前3个月收集的现场数据进行了横断面分析。283名参与者设计并完成了一份问卷。采用有调节多元回归对研究模型进行估计。提供者满意度、环境因素（沟通策略和工具功能价值）之间的相互作用以及患者激活和工具授权潜力之间的相互作用与使用PHR工具的行为意图显著相关（P< 0.05）。这些自变量共同解释了42%的行为意图差异。研究表明，个人因素和环境因素会影响PHR的使用意向。对医疗服务提供者满意度越高的患者使用意愿越高。对于那些认为该工具的卫生保健过程管理支持功能具有重要价值的患者，沟通策略有助于增加他们的使用意图。最后，那些相信该工具是授权的患者表现出更高的使用意愿，这在高度激活的患者中进一步增强。研究结果强调了沟通策略和技术特征的重要性，并对PHR实施的管理具有启示意义。
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. 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. 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. 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. 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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影响因子：
4.9
作者：
Agarwal, R;Sambamurthy, V;Stair, RM
通讯作者：
Stair, RM
DOI：
10.1136/jamia.2010.004671
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2011-03-01
影响因子：
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作者：
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DOI：
10.1197/jamia.m2835
发表时间：
2009-03-01
影响因子：
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作者：
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通讯作者：
Firek, Anthony