Exploring Patients' Use Intention of Personal Health Record Systems: Implications for Design

Personal health record (PHR) systems offer a technology for personal health information management (PHIM) activities. Despite efforts to increase the use of PHR systems as a mechanism to support better patient-centered care and improve information management across the continuum of care, PHR adoption remains low. The purpose of this study was to explore how to design a PHR system that can adequately support personal health information management activities. Using a mixed-methods approach (questionnaires and interviews), we identified the factors affecting a person's intention to use PHRs and also described the personal health information management activities among people from a wide age range in the United States. Results indicated that the intention to use PHR systems was affected by system-related factors, such as perceived usefulness, health information understandability, personalization, and patient-clinician communication support, and user-related factors, such as social influence, self-efficacy, and willingness to share. Furthermore, five types of personal health information management activities were found, including storage, organization, maintenance, retrieval, and sharing. Informed by the study findings, we developed seven design recommendations to improve PHR systems. Future studies can focus on further validating these findings using other methods and be based on larger and more representative PHR users.