Electronic Personal Health Records: A Matter of Trust

Abstract

<p>Early trials of Electronic Personal Health Records (ePHRs) show they provide two strong benefits: better healthcare outcomes and lower taxpayer costs. However, consumers are concerned about the possible loss or misuse of personal health data. For people to adopt ePHRs, they must trust both the system and the operating organization. The model presented here studies consumers’ likelihood of adopting ePHRs, combining trust, distrust, risk, motivation, and ease of use; as well as their perceptions of government, software vendors, and physicians as providers of ePHRs. Based on the Technology Acceptance Model, and incorporating elements of trust-distrust dualism and perceived risk, the model was tested empirically using survey data from 366 Canadian adults. The model explains 52 percent of the variance in the intention to use an ePHR, with strong negative effects from perceived risk and distrust, and strong positive effects from trust and perceived usefulness. Other findings include further evidence that trust and distrust are different constructs, not ends of a spectrum; that Canadians’ relationship with their healthcare system is complex; and that the risks in using an online system can be overcome by the perceived benefits. Open-ended responses show that people generally trust their doctors, but are sceptical that a doctor could provide a secure ePHR. Responses indicated that participants liked the consolidation of data and ease of access, but feared loss of privacy.</p>