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BMC Health Services Research

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Open Access 01-12-2024 | Research

How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France

Authors: Anna Griesser, Manel Mzoughi, Sonja Bidmon, Emna Cherif

Published in: BMC Health Services Research | Issue 1/2024

Abstract

Background

Electronic health records (EHR) are becoming an integral part of the health system in many developed countries, though implementations and settings vary across countries. Some countries have adopted an opt-out policy, in which patients are enrolled in the EHR system following a default nudge, while others have applied an opt-in policy, where patients have to take action to opt into the system. While opt-in systems may exhibit lower levels of active user requests for access, this contrasts with opt-out systems where a notable percentage of users may passively retain access. Thus, our research endeavor aims to explore facilitators and barriers that contribute to explaining EHR usage (i.e., actively accessing the EHR system) in two countries with either an opt-in or opt-out setting, exemplified by France and Austria.

Methods

A qualitative exploratory approach using a semi-structured interview guideline was undertaken in both countries: 1) In Austria, with four homogenously composed group discussions, and 2) in France, with 19 single patient interviews. The data were collected from October 2020 to January 2021.

Results

Influencing factors were categorized into twelve subcategories. Patients have similar experiences in both countries with regard to all facilitating categories, for instance, the role of health providers, awareness of EHR and social norms. However, we highlighted important differences between the two systems regarding hurdles impeding EHR usage, namely, a lack of communication as well as transparency or information security about EHR.

Conclusion

Implementing additional safeguards to enhance privacy protection and supporting patients to improve their digital ability may help to diminish the perception of EHR-induced barriers and improve patients’ health and commitment in the long term.

Practical implications

Understanding the differences and similarities will help to develop practical implications to tackle the problem of low EHR usage rates in the long run. This problem is prevalent in countries with both types of EHR default settings.

Available only for authorised users

The terms "Personal Health Records" (PHR) and "Electronic Health Records" (EHR) refer to distinct concepts in the realm of health information management. A Personal Health Record (PHR) typically involves health data managed by individuals, allowing them to store, track, and manage their health information. On the other hand, Electronic Health Records (EHR) encompass digitalized patient health records maintained by healthcare providers, facilitating comprehensive and centralized access to patient data within a healthcare institution [5].

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Title: How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France
Authors: Anna Griesser
Manel Mzoughi
Sonja Bidmon
Emna Cherif
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-024-10929-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France

Abstract

Background

Methods

Results

Conclusion

Practical implications

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Practical implications

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