Consumer Adoption of Personal Health Record Systems: A Self-Determination Theory Perspective: a journal appraisal by AMagno

Authors: Vahid Assadi, PhD; Khaled Hassanein, PhD

(J Med Internet Res 2017;19(7):e270) doi:10.2196/jmir.7721

To quote ” A personal health record (PHR) system is an information system that comprises data as well as supporting tools and functionalities related to an individual’s health”.

It is also described by Markle Foundation as ““An electronic application through which individuals can access, manage, and share their health information, and that of others for whom they are authorized, in a private, secure, and confidential environment.”

the main objectives of this article are:

  1. develop and validate a model to understand how a person’s perceptions of
    one’s health (self-determination) would influence their intentions to adopt
    PHR systems, and
  2. (2) assess the impacts of the environmental factor of physician autonomy support and the behavioral factor of individuals’ autonomous causality orientation on their
    perceptions of being self-determined in their health management behavior.

Figure 1: Proposed Theoretical Model of the studySDT



Data collection was done through an online survey (cross-sectional survey) to gather measurement scales for the model factors as well as gather individual characteristics (eg, demographics, details of previous computer and Internet use) and control variables.

Subjects: Individuals with no experience using personal health record (PHR) system.

  • After the survey, all participants are shown a video clip of the PHR system, to provide participants with introductory information about PHR systems and to show them how a PHR system can be used through a few real-life scenarios.

Result: Number of subjects: 159

Perceived Usefulness and Complexity: key antecedents of behavioral intention to use such systems

Self-efficacy- important indicator of complexity

Key Points:

  1. the Self-Determination Theory can be used as a model to test consumer adoption of a new system or technology.
  2. Individuals with higher levels of ability to manage their own health (self-determination) are more likely to adopt PHR systems since they have more positive perceptions regarding the use of such systems.
  3. Self-determination is fueled by autonomy support from consumers’ physicians as well as the consumers’ personality trait of autonomy orientation.

Lesson’s learned:

The SDT model can be used to test consumer adoption of a new system or technology. There points in the SDT model that trigger other points (example: Perceived usefulness and complexity contributes to the intention to use of the consumers.

How can this relate to the local setting in the Philippines?

Personal Health Record System is a new technology in the Philippines. It is even a newer system them the electronic medical record. But the impact and scope of this system can be huge especially in a field or condition where patients’ and/ or their relatives’ active participation are very important (eg cancer, diabetes mellitus, pregnancy).

In fact this will be the basis or topic of my possible thesis for this Masteral degree. Personal Health Records among pregnant women and their health care providers.




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