Using EMRs, as a Patient with Chronic Disease: Trend Analysis towards Online and Offline Factors Associated with Frequency of EMRs Utilization from 2014 to 2018


Electronic medical records (EMRs) are considered to be associated with a higher quality of healthcare in the US, yet also patients’ information privacy and security concerns. Despite the benefits of EMRs for chronic disease patients, there is a gap between the potential benefits of using EMRs and actual research. In fact, the EMRs adoption rate in the United States are still quite low. From the extent health information technology literature, existing studies are linked strongly with patients withholding their information due to the perceived risks of EMRs. The privacy concerns constrain chronic diseases patients’ information disclosure to healthcare providers, and reduce the frequency of using EMRs to communicate with health care providers. Apart from the privacy concern barrier of EMRs, offline clinical decision support systems and the alerts are also embedded with EMRs. However, little research is known that relationship between chronic diseases patients, health care provider, and EMRs yield mixed results from clinical aspects. Therefore, two contextual influences including privacy concern and clinical factors should be examined.

Being consistent with chronic conditions that need time to track diseases symptoms, to monitor symptoms changes and to improve ongoing treatments, using trend analysis towards this study related to EMRs utilization process can present continual evidence about how EMRs as health information technology is associated with privacy concerns and clinical factors. The arguments are what factors have an influence on the frequency of EMRs use, and how the factors change over time to impact EMRs adoption. Due to filling in the research gaps, this study postulates information holding, information safety, information maintenance, patient-centered communication, quality care rating, frequency of going health providers in predicting the frequency of using EMRs.

This research not merely analyses information privacy-related sides of EMRs objectively but also investigates the perceptions of patients with chronic diseases of online health information technology and offline patient-provider interaction as clinical factors to understand the frequency of EMRs adoption across HINTS data of 2014(N=2415), 2017(N=2253), and 2018(N=2443). Of greatest importance, what the paper found is that the rate of information holding as the manifestation of information privacy and security concerns kept decreasing through three waves. By contrast, the frequency of using EMRs is continually increasing, at three assessment points. Additionally, information safety, information maintenance and frequency of going health providers are significant predictors for the frequency of EMRs utilization over time. This study concluded that with no effects of privacy breach concerns presented as withholding behavior, the effectiveness of information safety toward technological safeguards and patient-provider interaction can buffer information privacy and security concerns. By comparison, advanced electronic health technology, as well as clinical factor referring to visiting health care providers, should work together in order to transform the healthcare system as a whole.

Electronic health system needs an integrated approach from appropriate measures. This study is a significant reference for improving the quality of healthcare via online electronic health system as well as offline clinical factors.