JMIR Publications

Background:

An electronic health record (EHR) system requires co-participation between individuals and medical staff in terms of completing the records, so staff can make accurate decisions that will reduce information asymmetry between themselves and the individuals providing the records. However, individuals may have the anxiety related to disclosing health information to the system. Therefore, understanding the factors that enable participation and willingness toward participating in the health record system is essential for researchers and hospital managers to encourage individual participation in the system.

Objective:

This study is mainly intended to develop a research model by adopting the Health Belief Model and Social Support Theory in order to understand the factors that facilitate individual willingness to use EHR systems for self-recording health information.

Methods:

A web-based questionnaire was used for the field survey used to obtain data from Taiwanese residents, and structural equation model (SEM) techniques were applied for the confirmatory factor analysis. The average variance extracted values and composite reliability were used to examine the convergent and discriminant validity of all items and the measurement scales. Lastly, structure equation modeling was used to test the seven hypotheses proposed in this work.

Results:

833 valid questionnaires were collected. The results of hypothesis testing show that the perceptions of seriousness and susceptibility reduced the threat-related anxiety in individuals (p < .001), in turn, causing them to use EHR systems to record their health information (P < .04). The perception of seriousness (p < .001) and susceptibility (P = .004) increased the degree of surveillance anxiety. Individuals take the initiative to record their health information due to support and recognition from the medical staff (P < .001), in turn reducing surveillance anxiety (P = .046; P < .001) and relational anxiety (P = .02) existing in the medical-patient relationship.

Conclusions:

It was found in this study that the development and implementation of EHR systems not only simultaneously makes it possible to educate the public about prevention of disease and increases awareness, encourages, and identifies the people who provide health information, but also assists the public with solving the problems associated with the use of the EHRs. Finally, the findings of this study suggest that governments and hospitals should develop information security that ensures the trust of individuals in the EHR, which in turn should promote and encourage the willingness of the public to use EHR systems and enhance overall medical quality and public services.

ClinicalTrial: