Patient Rationales Against the Use of Patient-Accessible Electronic Health Records: Qualitative Study.

Area of Science:

• Health Informatics
• Patient Engagement
• Digital Health Services

Background:

• Patient-accessible electronic health records (PAEHRs) offer internet-based access to personal health information.
• While many users have positive experiences, reasons for non-use remain underexplored.
• Understanding non-adoption is crucial for developing effective digital health services.

Purpose of the Study:

• To investigate the reasons why patients choose not to utilize online access to their health records.
• To identify patient rationales for non-engagement with PAEHRs.

Main Methods:

• Qualitative interviews were conducted with 40 internal medicine patients.
• Thematic content analysis was applied to interview transcripts.
• Focus was placed on understanding non-use of PAEHRs.

Main Results:

• Eight distinct rationales for PAEHR non-use were identified.
• Reasons included perceived lack of necessity, impersonal nature, incomprehensibility, focus on illness, fear, increased patient workload, digital competence issues, and skepticism towards digital transformation.
• Non-use is not solely due to practical barriers like access or hardware.

Conclusions:

• Patient non-adoption of PAEHRs stems from diverse, valid concerns beyond practical limitations.
• Digital health services should be promoted considering varied patient preferences and needs.
• The goal of digital health services may not always be universal uptake; recognizing diverse needs is essential.