1. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation Collaborative Research Forum March 30, 2012 Mihail CocosilaNorm Archer Athabasca UniversityMcMaster University Faculty of BusinessDeGroote School of Business

2. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 2 Agenda oIntroduction oResearch motivation oResearch objectives oTheoretical model oMethodology oKey findings oDiscussion oLimitations oFuture research

3. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 3 Introduction Unprecedented pressures in today’s society: provide better but also cost-effective care to an aging population affected by multiple health problems. One possible approach: encourage the support of healthcare Information Technology (IT) tools to provide information efficiently at the point of care. The most popular of these IT tools: Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems - computer-based clinical records for record keeping and data storage in healthcare institutions and physician offices.

4. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 4 … Introduction Personal Health Records (PHRs) tend to mirror EMRs or EHRs except that these newer electronic records are maintained by people monitoring their own health. Encouraging the use of PHRs may have positive consequences for all major stakeholders in the healthcare system: the general population receives better care while healthcare systems and society save money.

5. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 5 Research Motivation User perceptions and views - key elements for the success of any IT deployment. Important for sensitive fields like e-Health. A limited review of the topic “electronic personal health record(s)” and “user perceptions” found relatively few papers on this subject. Knowledge gap: Lack of a scientific understanding of the perceptions of the Canadian population about the potential for adoption of PHRs.

6. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 6 Research Objectives Important question: What are the key factors that influence intention to adopt PHRs? A well-documented body of research in information systems (IS): investigating user reasons to adopt a new IT. Various models and theories have been proposed and tested, depending on the IT artifact and context.

7. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 7 … Research Objectives Information-Related factors favouring PHRs: opersonal health knowledge; osatisfaction with their current medical care; oaccess to health data sources of interest; ohealth information-seeking preferences. Technology-Related factors favouring PHRs: oInternet reliance; ocomputer self-efficacy; opersonal IT innovativeness; osecurity, privacy, and trust in PHR systems; ocomputer anxiety.

8. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 8 … Research Objectives Research question: oWhat are the key information-related and technology-related factors that influence consumer perceptions of the adoption of electronic Personal Health Record systems?

9. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 9 Theoretical Model

10. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 10 Methodology Cross-sectional study with 400 participants in Canada recruited through a commercial firm. Including conditions: obe at least 18 years old; onot claiming to have a chronic illness. A total of 383 valid cases after removing incomplete ones. Data analysis: descriptive statistics, Partial Least Squares (PLS) modeling.

11. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 11 Key Findings Demographics: CharacteristicFindings Age (average)46.5 Gender57.7% Female, 42.3% Male Maintain up-to-date PHRs on paper19.2%Yes, 80.8% No Maintain up-to-date electronic PHRs5.8%Yes, 94.2% No Number of visits with a doctor during past 6 months (average) 2.3 Number of doctors seen during past 6 months (average)1.4 Number of children 12 years old or younger for whom they have main care responsibility at home (average) 0.3 The subject (or someone for whom they are responsible) has a chronic disease that requires continuing medical attention 21.2%Yes, 78.8% No The subject (or someone for whom they are responsible) has a disability that requires continuing care 11.0%Yes, 89.0% No Caring for elderly person(s)5.5%Yes, 94.5 % No Interested in regularly maintaining records about health64.4%Yes, 35.6% No Average amount of time spent using the Internet at home daily (largest two categories) Between 31 and 60 minutes 58.0%, Between 11 and 30 minutes 29.0%

12. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 12 … Key Findings Significance levels: * = 0.05; ** = 0.01; *** = 0.001 Assessment of Structural model

13. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 13 … Key Findings Total Effects on Behavioural Intention Coefficientp-Value Information Factors Personal Health Knowledge0.0230.198 Satisfaction with Medical Care-0.0070.627 Access to Data Sources0.0430.203 Information Seeking0.1110.154 Technology Factors Internet Reliance0.0280.206 Computer Self-Efficacy0.0950.112 Personal IT Innovativeness0.1650.014 Security, Privacy and Trust0.4870.000 Anxiety-0.1430.046

14. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 14 Discussion Answers to the research question (key information- related and technology-related factors that influence consumer perceptions of the adoption of electronic Personal Health Record systems) oSimilar to previous research, Perceived Usefulness is the single most important antecedent of the intention to use PHRs (path coefficient 0.570, significant at a 0.001 level); oFrom an information point of view, people would use PHRs only because they see the usefulness of these devices when seeking health information; oMost of the technology factors have a significant positive role in the adoption equation - computer self-efficacy is the only exception; oAs expected, computer anxiety has a negative significant influence.

15. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 15 … Discussion Answers to the research question Technology factors are more important than information factors in the adoption equation. As expected for a sensitive field, Security, Privacy and Trust is of outmost importance followed by Personal IT Innovativeness and Anxiety.

16. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 16 … Discussion Answers to the research question Possible explanation of the findings: participants were more consumers than patients (78.8% did not report having a chronic disease, 89% and 94.5% did not care for a person with disabilities or an elderly person, respectively). Participants were unlikely to be concerned about seeking medical information but seemed to be fairly experienced with the Internet and, thus, with computers and IT.

17. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 17 Limitations Sample convenience: from a panel of participants pre-recruited by a surveying firm. Actual medical condition of the participants was unknown since this was self-reported (e.g., having a chronic illness or not). Overall, not more limitations than those usually reported in relevant IS literature.

18. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 18 Future Research Look in more detail at possible other factors of adoption (e.g., risk perceptions). Contrast with other samples, including patients needing regular medical care. Experiment with exposing participants to PHR applications.

19. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 19 Message to Remember Before encouraging large scale deployments, it is critical to better understand consumer views of PHR systems and their potential for supporting better care, possibly at lower cost to society.

20. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 20 Paper submitted at the Eighteenth Americas Conference on Information Systems, Seattle, Washington, August 9-12, 2012.

21. Consumer Perceptions of the Adoption of Electronic Personal Health Records: An Empirical Investigation 21 Thank you! Questions? Mihail Cocosila, PhD Athabasca University, Faculty of Business mihailc@athabascau.ca