Division of Ergonomics, Department of Psychology and Ergonomics, Technische Universität Berlin, Berlin, Germany.
JMIR Hum Factors. 2024 Apr 10;11:e52625. doi: 10.2196/52625.
The rollout of the electronic health record (EHR) represents a central component of the digital transformation of the German health care system. Although the EHR promises more effective, safer, and faster treatment of patients from a systems perspective, the successful implementation of the EHR largely depends on the patient. In a recent survey, 3 out of 4 Germans stated that they intend to use the EHR, whereas other studies show that the intention to use a technology is not a reliable and sufficient predictor of actual use.
Controlling for patients' intention to use the EHR, we investigated whether disease-specific risk perceptions related to the time course of the disease and disease-related stigma explain the additional variance in patients' decisions to upload medical reports to the EHR.
In an online user study, 241 German participants were asked to interact with a randomly assigned medical report that varied systematically in terms of disease-related stigma (high vs low) and disease time course (acute vs chronic) and to decide whether to upload it to the EHR.
Disease-related stigma (odds ratio 0.154, P<.001) offset the generally positive relationship between intention to use and the upload decision (odds ratio 2.628, P<.001), whereas the disease time course showed no effect.
Even if patients generally intend to use the EHR, risk perceptions such as those related to diseases associated with social stigma may deter people from uploading related medical reports to the EHR. To ensure the reliable use of this key technology in a digitalized health care system, transparent and easy-to-comprehend information about the safety standards of the EHR are warranted across the board, even for populations that are generally in favor of using the EHR.
电子健康记录（EHR）的推出代表了德国医疗保健系统数字化转型的核心组成部分。尽管从系统角度来看，EHR 有望更有效地、更安全地、更快地治疗患者，但 EHR 的成功实施在很大程度上取决于患者。最近的一项调查显示，4 名德国人中有 3 名表示他们打算使用 EHR，而其他研究表明，使用技术的意愿并不是实际使用的可靠和充分的预测指标。
在控制患者使用 EHR 的意愿的情况下，我们研究了与疾病时间进程和疾病相关耻辱感相关的特定疾病风险感知是否可以解释患者将医疗报告上传到 EHR 的决策中的额外差异。
在一项在线用户研究中，要求 241 名德国参与者与随机分配的医疗报告进行交互，该报告在疾病相关耻辱感（高与低）和疾病时间进程（急性与慢性）方面存在系统差异，并决定是否将其上传到 EHR。
疾病相关耻辱感（优势比 0.154，P<.001）抵消了意图使用与上传决策之间的一般正向关系（优势比 2.628，P<.001），而疾病时间进程则没有影响。
即使患者普遍打算使用 EHR，与社会耻辱感相关的风险感知（例如与疾病相关的风险感知）也可能阻止人们将相关医疗报告上传到 EHR。为了确保在数字化医疗保健系统中可靠地使用这项关键技术，即使是普遍支持使用 EHR 的人群，也需要全面提供有关 EHR 安全标准的透明且易于理解的信息。
