Emani Srinivas, Peters Ellen, Desai Sonali, Karson Andrew S, Lipsitz Stuart R, LaRocca Rajani, Stone John, Suric Vlas, Wald Jonathan S, Wheeler Amy, Williams Deborah H, Bates David W
Lab for Computer Science Massachusetts General Hospital Harvard Medical School Boston, MA.
Department of Psychology The Ohio State University Columbus, OH.
J Innov Health Inform. 2018 Oct 25;25(3):149-157. doi: 10.14236/jhi.v25i3.991.
Patient portals have emerged as an important tool through which patients can access online health information and engage in their health care. However, we know little about how patients perceive portals and whether patient perceptions might influence portal adoption.
Apply the diffusion of innovation (DOI) theory to assess perceptions of adopters and non-adopters of a patient portal.
We conducted a cross-sectional survey of adopters and non-adopters of the portal. Our survey consisted of perceived attributes from the DOI theory, socio-demographic characteristics and patient perceptions of technology adoption.
Three factors representing perceived attributes from DOI theory accounted for 73% of the variance in the data: Factor 1 - Relative Advantage (27%); Factor 2 - Ease of Use (24%) and Factor 3 - Trialability (22%). Adopters perceived greater Relative Advantage [mean (SD)] = 3.8 (0.71) versus 3.2 (0.89), p < 0.001, Ease of Use = 4.1 (0.71) versus 3.3 (0.95), p < 0.001 and Trialability = 4.0 (0.57) versus 3.4 (0.99), p < 0.001 than non-adopters. In multivariate modelling, age [OR = 3.75, 95% CI: (2.17, 6.46), p < 0.001] and income [OR = 1.87, 95% CI: (1.17, 3.00), p < 0.01] predicted adoption of the portal. Among DOI factors, Relative advantage predicted adoption of the portal [OR = 1.48, 95% CI: (1.03, 2.11), p < 0.05].
Patients will adopt a patient portal if they perceive it to offer a relative advantage over existing practices such as telephoning or visiting the doctor's office. Organisations seeking to increase the adoption of patient portals should implement strategies to promote the relative advantage of portals as, for example, through posters in waiting and exam rooms. A digital divide in the adoption of patient portals may exist with respect to age and income.
患者门户网站已成为一种重要工具，患者可通过它获取在线健康信息并参与自身医疗保健。然而，我们对患者如何看待门户网站以及患者的看法是否会影响门户网站的采用知之甚少。
应用创新扩散（DOI）理论评估患者门户网站采用者和未采用者的看法。
我们对该门户网站的采用者和未采用者进行了横断面调查。我们的调查包括来自DOI理论的感知属性、社会人口统计学特征以及患者对技术采用的看法。
代表DOI理论感知属性的三个因素占数据方差的73%：因素1 - 相对优势（27%）；因素2 - 易用性（24%）和因素3 - 可试用性（22%）。与未采用者相比，采用者感知到更大的相对优势[均值（标准差）]=3.8（0.71）对3.2（0.89），p<0.001，易用性=4.1（0.71）对3.3（0.95），p<0.001，可试用性=4.0（0.57）对3.4（0.99），p<0.001。在多变量建模中，年龄[比值比=3.75，95%置信区间：（2.17，6.46），p<0.001]和收入[比值比=1.87，95%置信区间：（1.17，3.00），p<0.01]可预测门户网站的采用情况。在DOI因素中，相对优势可预测门户网站的采用情况[比值比=1.48，95%置信区间：（1.03，2.11），p<0.05]。
如果患者认为患者门户网站比诸如打电话或去医生办公室等现有方式具有相对优势，他们就会采用该门户网站。寻求提高患者门户网站采用率的组织应实施策略来促进门户网站的相对优势，例如通过在候诊室和检查室张贴海报。在患者门户网站的采用方面，可能存在年龄和收入方面的数字鸿沟。
