Exploring electronic personal health record adoption in Piedmont, Italy: a cross-sectional analysis

Background: The electronic personal health record (EPHR) is a digital summary of one's health information, and despite its proven effectiveness, it has been widely underutilised. Objective: To evaluate attitudes and behaviours regarding the EPHR among citizens in Piedmont, Italy, who had activated this tool, and to identify specific obstacles and potential predictors of its usage. Method: A cross-sectional study was conducted between March and December 2022 using web-based and paper-based surveys distributed across social media and healthcare facilities. Univariate and multivariate logistic regression models were used to assess variables that could affect EPHR utilisation, with significance set at p < 0.05. Results: The analyses included 710 participants who had activated and accessed their EPHR. Those with higher educational levels accessed their EPHR more often and reported a lower perceived ease of access. Unemployed participants and those perceiving the EPHR as containing comprehensive information were more likely to use the EPHR. Privacy concerns among this sample were minimal. Conclusion: The study highlighted important barriers to the use of the EPHR, particularly among older adults and individuals with lower levels of education, who tended to use the tool less frequently. This suggests the need for targeted actions to improve access and ease of use. Increasing digital skills among citizens and healthcare professionals is key to making the EPHR a truly effective tool for patient care and health system efficiency. Implications for health information management practice: Improving the EPHR interface, providing user support and increasing healthcare professionals' engagement are essential strategies to boost EPHR adoption and improve healthcare outcomes.