IAE Clermont Auvergne School of Management - CleRMa, - Research chair "health and territories", University Clermont Auvergne, Clermont-Ferrand, France.
ICD International Business School - LARA, Management Department, Paris, France.
Public Health. 2022 Jun;207:46-53. doi: 10.1016/j.puhe.2022.03.010. Epub 2022 Apr 26.
Patients' adoption of electronic health records (EHRs) varies substantially. Although some countries, such as Estonia and Denmark, are sufficiently advanced in terms of EHR generalisation, others, such as France, are figuring out how to implement and disseminate EHRs. These governments must respond to patients' disparities to achieve the expected performance for healthcare systems and improve the quality of care delivery. This study investigates patients' perceived benefits and privacy concerns related to EHRs to develop a typology of patients, identify the characteristics of different clusters and propose practical measures for public policy-makers.
We conducted a cross-sectional study using online questionnaires.
An online quantitative survey was carried out in France. The final sample of EHR non-users (N = 1076) was fitted to be representative of the French population by age and gender, region and socioprofessional status. Hierarchical and non-hierarchical cluster analyses were performed. Several robustness check analyses were also performed.
Cluster analyses identified four patient clusters: the worried, who show the highest mean privacy concern and risk levels related to health data disclosure; the ready adopters, who lack privacy concerns and risk and are the most motivated by EHR benefits; the concerned adopters, who express far fewer privacy concerns and perceive EHR benefits more favourably than the worried adopters; and the balanced adopters, who are relatively similar to the ready adopters in their EHR motives and are still concerned about their health data, suggesting a segment that is easier to convince. Comparing clusters regarding the intentions to create EHRs and willingness to disclose health data confirms that ready adopters, followed by balanced adopters, are more likely to create an EHR and disclose health data. The concerned adopters and, finally, the worried exhibit the lowest intentions for EHR creation and data disclosure.
The results provide meaningful insights into patient profiles and expectations. The findings underscore the need to implement targeting policies for each cluster and design concrete solutions for improving EHR performance.
患者对电子健康记录 (EHR) 的采用程度存在很大差异。尽管有些国家，如爱沙尼亚和丹麦，在 EHR 推广方面已经相当先进，但其他国家，如法国，仍在探索如何实施和传播 EHR。这些国家的政府必须应对患者之间的差异，以实现医疗体系的预期绩效并提高护理质量。本研究旨在调查患者对 EHR 的感知益处和隐私顾虑，以对患者进行分类，确定不同群体的特征，并为公共政策制定者提出切实可行的措施。
我们采用横断面研究设计，通过在线问卷进行。
在法国进行了一项在线定量调查。通过年龄、性别、地区和社会职业地位对 EHR 非使用者（N=1076）的最终样本进行了代表性调整。进行了层次聚类分析和非层次聚类分析。还进行了几种稳健性检查分析。
聚类分析确定了四个患者群体：担忧者，他们表现出最高的隐私关注和与健康数据披露相关的风险水平；准备采用者，他们对隐私问题和风险缺乏关注，并且最受 EHR 益处的激励；关注采用者，他们对隐私问题的关注程度远低于担忧者，并且对 EHR 益处的看法更为有利；以及平衡采用者，他们在 EHR 动机方面与准备采用者相对相似，并且仍然对自己的健康数据表示关注，这表明他们是一个更容易被说服的群体。比较不同群体关于创建 EHR 和披露健康数据的意愿，证实了准备采用者（其次是平衡采用者）更有可能创建 EHR 并披露健康数据。而关注采用者，最后是担忧者，对创建 EHR 和披露健康数据的意愿最低。
结果为患者的特征和期望提供了有意义的见解。研究结果强调了为每个群体实施有针对性的政策和设计具体解决方案以改善 EHR 性能的必要性。
