title: Consumers' perceptions about and use of the internet for personal health records and health information exchange: analysis of the 2007 Health Information National Trends Survey.
abstract: BACKGROUND
  Personal health records (PHRs) and the sharing of health information through health information exchange (HIE) have been advocated as key new components in the effective delivery of modern health care. It is important to understand consumer attitudes toward utilization of PHRs and HIE to evaluate the public's willingness to adopt these new health care tools.
  
  
  OBJECTIVE
  The purpose of this study was to examine consumer attitudes toward PHRs and their health care providers' use of HIE, as well as to evaluate consumer use of the Internet for tracking PHRs.
  
  
  METHODS
  Analysis of data from the 2007 iteration of the Health Information National Trends Study (HINTS, N=7674) was conducted using multivariate logistic regression to identify predictors of consumer (1) appraisal of PHRs, (2) appraisal of health care provider use of HIE, and (3) use of the Internet for tracking PHRs.
  
  
  RESULTS
  Approximately 86% of US adults rated electronic access to their PHRs as important. However, only 9% of them used the Internet for tracking PHRs. Those who rated electronic access to their PHRs as important were more likely to be Hispanic (odds ratio [OR] = 1.34, 95% confidence interval [CI] 1.04 - 1.72) and Internet users (OR = 1.27, 95% CI = 1.02 - 1.57) and less likely to be age 65 and above (OR = 0.50, 95% CI = 0.38 - 0.67) or individuals whose doctors always ensured their understanding of their health (OR = 0.62, 95% CI = 0.49 - 0.78). Those who rated HIE as important were more likely to be 45 to 54 years of age (OR = 1.46, 95% CI = 1.03 - 2.08), 55 to 64 years of age (OR = 1.83, 95% CI = 1.32 - 2.53), or 65 and above (OR = 1.76, 95% CI = 1.27 - 2.43) and less likely to be women (OR = 0.80, 95% CI = 0.68 - 0.95) or individuals who perceive their health information as not safely guarded by their doctors (OR = 0.53, 95% CI = 0.40 - 0.69). Among Internet users, those who used the Internet to track their PHRs were more likely to be college graduates (OR = 1.84, 95% = 1.32 - 2.59) or to have completed some college courses (OR = 1.46, 95% CI = 1.02 - 2.11), to be Hispanic (OR = 1.92, 95% CI = 1.23 - 2.98), or to be individuals with health care provider access (OR = 1.90, 95% CI = 1.21 - 2.97). Women were less likely to use the Internet for tracking PHRs than men (OR = 0.78, 95% CI = 0.61 - 1.00).
  
  
  CONCLUSIONS
  Despite widespread positive appraisal of electronic access to PHRs as important, Internet use for tracking PHRs remains uncommon. To promote PHR adoption, the digital divide associated with the gap in health literacy must be improved, and cultural issues and the doctor-patient relationship need to be studied. Further work also needs to address consumer concerns regarding the security of HIE.
authors.affiliation: Psychosocial and BioBehavioral Medicine, Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia 19111, United States. Kuang-Yi.Wen@fccc.edu
authors.forename: Kuang-Yi
authors.initials: KY
authors.lastname: Wen
authors.forename: Gary
authors.initials: G
authors.lastname: Kreps
authors.forename: Fang
authors.initials: F
authors.lastname: Zhu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Miller
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016001:Confidence Intervals; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D054626:Consumer Health Information / Q000706:statistics & numerical data / Q000639:trends*; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D055991:Health Records, Personal; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology; D055815:Young Adult