Examining Acceptance of an Integrated Personal Health Record (PHR)

Objective: The purpose of this project was to examine the practice question, “What are the factors influencing acceptance of integrated PHRs for self-care management among the Howard University Hospital (HUH) Diabetes Treatment Clinic (DTC) patients?” These factors include a) demographic characteristics, b) computer access/use/experience, including health and computer literacy, and the technology acceptance model (TAM) constructs of (c) patient’s perceived usefulness, (d) perceived ease of use, and (e) behavioral intention to use the clinic’s free and integrated PHR for self-care management. Design: A non-experimental descriptive, cross-sectional survey design was employed using a convenience sample of adult diabetic patients attending the DTC to be seen by their provider during 28 March to 26 May, 2011. DTC patients with diabetes were invited to participate in the survey appropriate to their PHR status: PHR user or PHR non-user. Voluntary completion of these surveys occurred during the clinic visit. Results: During the study period 29% of the clinic’s total adult patients with diabetes presented for care, with 26.8% of those participating in this survey. A total of 78 surveys were completed, 48 representing DTC PHR users (61.5%) and 30 non-users (38.5%). A significantly higher proportion of respondents having the DTC PHR had a higher level of education compared with PHR non-users, x2 = .04 (1, 77), p = .039. Additionally, a higher proportion of DTC PHR users had access to the Internet compared to PHR non-users, 93.3% vs. 62.1% respectively, x2 = 9 (1, 73), p =.003. PHR users, M = 4.00, SD = .80, more strongly agree that the PHR is easy to use than non-users, M = 3.43, SD = .88; t(68) = 2.82, p = .006. Finally, PHR users more strongly believe their doctor wants them to use a PHR compared to non-users, M = 4.02, SD = .76, & M = 3.57, SD = .74, respectively; t(67) = 2.46, p = .017. Conclusions: Both users and non-users of the HUH DTC PHR intend to use the PHR, perceive the PHR is/could become easy to use, and believe the PHR is useful for self-managing their care and diabetes. There is a significant awareness, education, Internet access, and perceived initial ease of use difference between the users and non-users in this setting. The DTC staff could increase PHR adoption in this setting by continued and more prominent promotion of the PHR while addressing access and computer/PHR literacy and ease of use needs among the potentialadopters