Understanding factors influencing intention to use electronic health records (EHRS): an integration of multiple theoretical perspectives

Rahman, Mohammed Sajedur
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Electronic Health Records (EHRs) are expected to make a significant impact in transforming the healthcare industry. While healthcare organizations are increasingly adopting EHRs, very little is known to date about patients' perceptions and their behavioral intention to use this emerging technology. Researchers and practitioners agree that understanding patients' perceptions toward EHRs is critical for the successful diffusion of this healthcare technology (Angst and Agarwal 2009; Sun et al. 2013). However, a review of the EHRs literature revealed a lack of research focused on the patients' perspective. In addition, existing healthcare technology adoption research is primarily grounded in theories in the field of Information Systems (IS). This study proposes and empirically tests an integrated causal predictive model incorporating theories from Information Systems, Health Psychology, and Organizational Psychology to understand the health-related factors as well as technology-related factors influencing patient's behavioral intention to use EHRs. To empirically test the research model, a survey was administered among 368 participants. Employing the Partial Least Squares (PLS) technique, a Structural Equation Modeling (SEM) tool, this study shows that individuals' health technology adoption behavior not only depends on technology-related factors but health-related factors are also found important in this context. Among the health-related factors, patients' health benefit perception was found to have the strongest influence on their behavioral intention to use the EHRs, followed by cues to action. Both technology-related factors, health information privacy concern and health information security concern, were also found to play a significant role. Several antecedent factors for the formation of patients' health information privacy and security concerns were also identified. Contrary to the expectation, the results of this study indicated that patients' severity of illness (health status emotion) perception is not a significant factor that moderates patients' health technology related decision making, which may need further investigation in the future. This study extends the use of health psychology theory in the Information Systems domain and technology threat behavior theory in the healthcare domain in the context of health technology adoption behavior. In addition, this study provides a holistic view about the health and technology related factors that are important in patients' health technology adoption decision making process. This study also provides important insight about the formation of patients' technological threat behavior. Finally, the results of this study provide several important theoretical and practical implications in the diffusion of technology in the healthcare domain.

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EHR, EHR Adoption Factors, Electronic Health Records, Healthcare Information Systems, Patient Perception
Information Systems and Cyber Security