Published in:
Open Access 01-12-2017 | Research article
Electronic Health Record Portal Adoption: a cross country analysis
Published in: BMC Medical Informatics and Decision Making | Issue 1/2017
Login to get accessAbstract
Background
This study’s goal is to understand the factors that drive individuals to adopt Electronic Health Record (EHR) portals and to estimate if there are differences between countries with different healthcare models.
Methods
We applied a new adoption model using as a starting point the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) by incorporating the Concern for Information Privacy (CFIP) framework. To evaluate the research model we used the partial least squares (PLS) – structural equation modelling (SEM) approach. An online questionnaire was administrated in the United States (US) and Europe (Portugal). We collected 597 valid responses.
Results
The statistically significant factors of behavioural intention are performance expectancy (\( \widehat{\beta} \)
total = 0.285; P < 0.01), effort expectancy (\( \widehat{\beta} \)
total = 0.160; P < 0.01), social influence (\( \widehat{\beta} \)
total = 0.198; P < 0.01), hedonic motivation (\( \widehat{\beta} \)
total = −0.141; P < 0.01), price value (\( \widehat{\beta} \)
total = 0.152; P < 0.01), and habit (\( \widehat{\beta} \)
total = 0.255; P < 0.01). The predictors of use behaviour are habit (\( \widehat{\beta} \)
total = 0.145; P < 0.01), and behavioural intention (\( \widehat{\beta} \)
total = 0.480; P < 0.01). Social influence, hedonic motivation, and price value are only predictors in the US group. The model explained 53% of the variance in behavioural intention and 36% of the variance in use behaviour.
Conclusions
Our study identified critical factors for the adoption of EHR portals and significant differences between the countries. Confidentiality issues do not seem to influence acceptance. The EHR portals usage patterns are significantly higher in US compared to Portugal.