Abstract
Personal health records (PHRs) are seen as the bedrock of patient engagement. They have the potential to improve health outcomes for individual healthcare consumers, providers, and the broader healthcare system. With Meaningful Use Stage 2 now mandating the implementation of tethered PHRs (as patient portals), will healthcare consumers actually use PHRs and realize the contributions to patient safety, quality care, efficiencies, and reduced health disparities through engagement? Or will PHR actual use remain low? In this interpretive qualitative study, using grounded theory, we asked healthcare consumers users they currently manage their personal health information (PHI) and why. Evidence from our study iterates to the lazy user theory, we found that letting physicians manage healthcare consumers PHI is the least effort-based solution and thus the predominant and preferred solution by healthcare consumers. Providers as guardians of patient PHI suggest that the low use rates may yet persist. The implicit equating of personal health information as provider-generated health information by both healthcare consumers and the designers of PHR tools they use blurs the value proposition for consumers.
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
In attempts to comply with the law, physicians and physician groups made patients enroll to the patient portal during a patient visit.
References
Abramson, E. L., Patel, V., Edwards, A., & Kaushal, R. (2014). Consumer perspectives on personal health records: A 4-community study. American Journal of Managed Care, 20, 287–a298.
Agency for Healthcare Research and Quality. (2017). About the national quality strategy. Agency for Healthcare Research and Quality. https://www.ahrq.gov/workingforquality/about/index.html. Accessed 22 Sept 2018.
Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In Action control (pp. 11–39). Berlin, Heidelberg: Springer.
Ajzen, I., & Fishbein, M. (1975). Belief, attitude, intention and behavior: An introduction to theory and research. Reading: Addison-Wesley.
Alter, S. (2010). Designing and engineering for emergence: A challenge for HCI practice and research. AIS Transactions on Human-Computer Interaction, 2(4), 127–140.
Ancker, J. S., Osorio, S. N., Cheriff, A., Cole, C. L., Silver, M., & Kaushal, R. (2015). Patient activation and use of an electronic patient portal. Informatics for Health & Social Care, 40, 254–266.
Archer, N., Fevrier-Thomas, U., Lokker, C., McKibbon, K. A., & Straus, S. E. (2011). Personal health records: A scoping review. Journal of the American Medical Informatics Association, 18, 515–522.
Association, A. H. (2018). Expanding electronic patient engagement. Annual Survey, IT Supplement Brief March.
Bagozzi, R. P., Davis, F. D., & Warshaw, P. R. (1992). Development and test of a theory of technological learning and usage. Human Relations, 45, 659–686.
Bhaumik, S. K., & Piesse, J. (2008). Does lending behaviour of banks in emerging economies vary by ownership? Evidence from the Indian banking sector. Economic Systems, 32, 177–196.
Borfitz, D. (2018). Blockchain-secured, patient-controlled health records. https://www.clinicalinformaticsnews.com/2018/05/08/real-world-blockchain-applications-in- healthcare.aspx.
Bouri, N., & Ravi, S. (2014). Going mobile: How mobile personal health records can improve health care during emergencies. JMIR mHealth and uHealth, 2, e8.
Carrión, I., Alemán, J. L. F., & Toval, A. (2011). Assessing the HIPAA standard in practice: PHR privacy policies. In: Engineering in Medicine and Biology Society, EMBC, 2011 Annual International Conference of the IEEE, 2011. IEEE, pp 2380–2383.
Collan, M., & Tétard, F. (2011). Lazy user model: Solution selection and discussion about switching costs. In Scandinavian conference on information systems (pp. 56–68). Berlin, Heidelberg: Springer.
Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 12, 319–340.
Davis, F. D., Bagozzi, R. P., & Warshaw, P. R. (1989). User acceptance of computer technology: A comparison of two theoretical models. Management Science, 35, 982–1003.
Department of Health and Human Services CfMaMS. (2010). 42 CFR parts 412, 413, 422 et al. Medicare and medicaid programs: Electronic health record incentive program; Final Rule.
DiCicco-Bloom, B., & Crabtree, B. F. (2006). The qualitative research interview. Medical Education, 40, 314–321.
Fishbein, M., & Ajzen, I. (1977). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading: Addison-Wesley.
Goodhue, D. L. (1995). Understanding user evaluations of information systems. Management Science, 41, 1827–1844.
Goodhue, D. L., & Thompson, R. L. (1995). Task-technology fit and individual performance. MIS Quarterly, 7, 213–236.
Houston, T. K., & Ehrenberger, H. E. (2001). The potential of consumer health informatics. Seminars in Oncology Nursing, 17, 41–47. https://doi.org/10.1053/sonu.2001.20418.
Jones, D. A., Shipman, J. P., Plaut, D. A., & Selden, C. R. (2010). Characteristics of personal health records: Findings of the medical library association/national library of medicine joint electronic personal health record task force. Journal of the Medical Library Association: JMLA, 98, 243.
Kaelber, D. C., Jha, A. K., Johnston, D., Middleton, B., & Bates, D. W. (2008). A research agenda for personal health records (PHRs). Journal of the American Medical Informatics Association, 15, 729–736.
Kavoussi, S., Huang, J., Tsai, J., & Kempton, J. (2014). HIPAA for physicians in the information age. Connecticut Medicine, 78, 425–427.
Kim, J., Jung, H., & Bates, D. W. (2011). History and trends of “personal health record” research in PubMed. Healthcare Informatics Research, 17, 3–17. https://doi.org/10.4258/hir.2011.17.1.3.
Kunene, K. N., Zysk, K., & Diop, M. -F. (2016). Healthcare consumers’ voluntary adoption and non- adoption of electronic personal health records. In: The 27th Australasian Conference on Information Systems, Wollongong, NSW, Australia, 2016. University of Wollongong, Faculty of Business.
Lafky, D. B., & Horan, T. A. (2011). Personal health records: Consumer attitudes toward privacy and security of their personal health information. Health Informatics Journal, 17, 63–71.
Lee, A. S., & Baskerville, R. L. (2003). Generalizing generalizability in information systems research. Information Systems Research, 14, 221–243.
Lehnbom, E., Douglas, H., & Makeham, M. (2016). Positive beliefs and privacy concerns shape the future for the personally controlled electronic health record. Internal Medicine Journal, 46, 108–111.
Lester, M., Boateng, S., Studeny, J., & Coustasse, A. (2016). Personal health records: Beneficial or burdensome for patients and healthcare providers? Perspectives in Health Information Management, 13, 115–118.
Mitchell, B., & Begoray, D. (2010). Electronic personal health records that promote self-management in chronic illness. OJIN: The Online Journal of Issues in Nursing, 15, 1B–10B.
Patel, V., & Johnson, C. (2018). Individuals’ use of online medical records and technology for health needs (Vol. 40). Washington, DC: Office of the National Coordinator.
Patel, V. N., et al. (2011). Low-income, ethnically diverse consumers’ perspective on health information exchange and personal health records. Informatics for Health & Social Care, 36, 233–252.
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Free Press.
Saparova, D. (2012). Motivating, influencing, and persuading patients through personal health records: A scoping review. Perspectives in Health Information Management, 1 243–249.
Schutz, A. (1962). Concept and theory formation in the social sciences. In Collected papers I (pp. 48–66). Dordrecht: Springer.
Señor, I. C., Fernández-Alemán, J. L., & Toval, A. (2012). Are personal health records safe? A review of free web-accessible personal health record privacy policies. Journal of Medical Internet Research, 14, e114.
Services CfMaM. (2018). Promoting interoperability. Centers for Medicare and Medicaid Services. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms. Accessed 22 Sept 2018.
Sheppard, B. H., Hartwick, J., & Warshaw, P. R. (1988). The theory of reasoned action: A meta-analysis of past research with recommendations for modifications and future research. Journal of Consumer Research, 15, 325–343.
Showell, C. (2017). Barriers to the use of personal health records by patients: A structured review. PeerJ, 5, e3268.
Spil, T., & Klein, R. (2014). Personal health records success: why Google health failed and what does that mean for Microsoft HealthVault? In: 2014 47th Hawaii International Conference on System Sciences (HICSS), 2014. IEEE, pp 2818–2827.
Strauss, A., & Corbin, J. (1990). Basics of qualitative research (Vol. 15). Newbury Park: Sage.
Strauss, A., & Corbin, J. (1994). Grounded theory methodology. Handbook of Qualitative Research, 17, 273–285.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Second edn. Thousand Oaks: Sage Publications.
Studeney and Coustasse with https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832132/.
Taha, J., Czaja, S. J., Sharit, J., & Morrow, D. G. (2013). Factors affecting usage of a personal health record (PHR) to manage health. Psychology and Aging, 28, 1124.
Tang, P. C., Ash, J. S., Bates, D. W., Overhage, J. M., & Sands, D. Z. (2006). Personal health records: Definitions, benefits, and strategies for overcoming barriers to adoption. Journal of the American Medical Informatics Association, 13, 121–126.
Tétard, F., & Collan, M. (2009). Lazy user theory: A dynamic model to understand user selection of products and services. In: System Sciences, 2009. HICSS’09. 42nd Hawaii International Conference on, 2009. IEEE, pp 1–9.
Van Maanen, J. (1983). Reclaiming qualitative methods for organizational research: A preface. In J. Van Maanen (Ed.), Qualitative methodology. Beverly Hills: Sage.
Vance, B., Tomblin, B., Studeny, J., & Coustasse, A. (2014). Personal health records: Benefits and barriers for its adoption. Insights to a Changing World Journal, 2014, 48–67.
Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 12, 425–478.
Vessey, I. (1991). Cognitive fit: A theory-based analysis of the graphs versus tables literature. Decision Sciences, 22, 219–240.
Vessey, I., & Galletta, D. (1991). Cognitive fit: An empirical study of information acquisition. Information Systems Research, 2, 63–84.
Vydra, T. P., Cuaresma, E., Kretovics, M., & Bose-Brill, S. (2015). Diffusion and use of tethered personal health records in primary care. Perspectives in Health Information Management, 12, 109–114.
Wagner, P. J., Dias, J., Howard, S., Kintziger, K. W., Hudson, M. F., Seol, Y.-H., & Sodomka, P. (2012). Personal health records and hypertension control: A randomized trial. Journal of the American Medical Informatics Association, 19, 626–634.
Wunsch, G. (1982). Maternal and child health in the third world: Problems of data collection. Popul Famille, 53, 19–33.
Wynia, M., & Dunn, K. (2010). Dreams and nightmares: Practical and ethical issues for patients and physicians using personal health records. The Journal of Law, Medicine & Ethics, 38, 64–73.
Yamin, C. K., Emani, S., Williams, D. H., Lipsitz, S. R., Karson, A. S., Wald, J. S., & Bates, D. W. (2011). The digital divide in adoption and use of a personal health record. Archives of Internal Medicine, 171, 568–574.
Young, R., Willis, E., Cameron, G., & Geana, M. (2014). “Willing but unwilling”: Attitudinal barriers to adoption of home-based health information technology among older adults. Health Informatics Journal, 20, 127–135. https://doi.org/10.1177/1460458213486906.
Zapata, B. C., Niñirola, A. H., Idri, A., Fernández-Alemán, J. L., & Toval, A. (2014). Mobile PHRs compliance with android and iOS usability guidelines. Journal of Medical Systems, 38, 81.
Zipf, G. (1949). Human behavior and the principle of least effort. Reading: Addison-Wesley.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Appendix
Appendix
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Kunene, K.N. (2020). A Lazy User Perspective to Patient Adoption and Use of Personal Health Records. In: Wickramasinghe, N., Bodendorf, F. (eds) Delivering Superior Health and Wellness Management with IoT and Analytics. Healthcare Delivery in the Information Age. Springer, Cham. https://doi.org/10.1007/978-3-030-17347-0_30
Download citation
DOI: https://doi.org/10.1007/978-3-030-17347-0_30
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-17346-3
Online ISBN: 978-3-030-17347-0
eBook Packages: MedicineMedicine (R0)