As the use of the
Internet and mobile technology has increased significantly, individuals
increasingly rely on these services to access and review personal information
provided by governments and companies. The healthcare industry is no exception.
Healthcare providers actively encourage patients to adopt and regularly use
patient portals, expecting to reduce administrative costs and enhance service
efficiency and effectiveness in managing patient information. In the early
2000s, healthcare providers primarily emphasized patients’ initial adoption of
these technologies. Accordingly, much of the early research focused on the
determinants of initial adoption of online personal health records (PHRs).
However, as most patients have now adopted and used online PHR systems, recent
research has shifted toward examining usage intensity and users’ confidence in
utilizing online PHR platforms. Given these recent trends, this study
investigates the mediating role of self-efficacy in determining the level of
online PHR usage. This study utilizes publicly available data from the Health
Information National Trends Survey (HINTS). The primary objective is to identify the
factors influencing the level of online PHRs usage, with particular emphasis on
the mediating effect of self-efficacy. After data cleaning and validating
procedures, structural equation modeling (SEM) was employed to analyze data.
The results indicate that Self-Efficacy, Information Trust and Sharing, Ease of
Understanding, and Technology Competency significantly influence the level of
online PHR usage. In addition, Self-Efficacy was significantly affected by
Information Trust and Sharing, Perceived Value of Information, Ease of
Understanding, and Technology Competency. However, although Perceived Value of
Information significantly explains the level of Self-Efficacy, it does not have
a statistically significant direct effect on the level of online PHR usage.
Similarly, Ease to Communicate does not significantly explain the level of
online PHR usage. Based on these findings, healthcare providers should focus on
enhancing patients’ confidence in using online PHR systems by improving the
reliability and perceived value of information. This study contributes to
literature by shifting focus from initial adoption to continued usage and by
highlighting the mediating role of self-efficacy in online PHR utilization.
Practically, the findings offer guidance for improving the design and
functionality of the current online PHR platforms.
