title: Understanding adoption of a personal health record in rural health care clinics: revealing barriers and facilitators of adoption including attributions about potential patient portal users and self-reported characteristics of early adopting users.
abstract: Personal health records (PHRs) are important for improving patient care. An important prerequisite to realize benefits of PHR use is patient recruitment. To understand clinic barriers to adoption, we used Rogers' Diffusion of Innovations theory to frame an examination of clinic staff perceptions of a new PHR and perceptions of likely patient portal users. Clinic staff reported many relative advantages and observable benefits of the PHR but also some distinct problems. Attributions about potential patient users included demographic, computer use, and personality characteristics staff expected in likely users. Analysis of patient survey data of early adopters compared to non-users revealed discrepancies between clinic staff expectations and early adopters' self-reports. Implications for improving adoption of PHRs include ensuring compatibility with existing systems and avoiding recruitment biases.
authors.affiliation: Department of Psychology, University of Utah ; VA Salt Lake City Health Care System.
authors.forename: Jorie M
authors.initials: JM
authors.lastname: Butler
authors.affiliation: Internal Medicine, University of Utah School of Medicine ; VA Salt Lake City Health Care System.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Carter
authors.affiliation: Internal Medicine, University of Utah School of Medicine.
authors.forename: Candace
authors.initials: C
authors.lastname: Hayden
authors.affiliation: Departments of Biomedical Informatics, University of Utah School of Medicine ; VA Salt Lake City Health Care System.
authors.forename: Bryan
authors.initials: B
authors.lastname: Gibson
authors.affiliation: Departments of Biomedical Informatics, University of Utah School of Medicine ; VA Salt Lake City Health Care System.
authors.forename: Charlene
authors.initials: C
authors.lastname: Weir
authors.affiliation: Utah Department of Health ; HealthInsight, Salt Lake City, UT.
authors.forename: Laverne
authors.initials: L
authors.lastname: Snow
authors.affiliation: Internal Medicine, University of Utah School of Medicine.
authors.forename: Jose
authors.initials: J
authors.lastname: Morales
authors.affiliation: HealthInsight, Salt Lake City, UT.
authors.forename: Anne
authors.initials: A
authors.lastname: Smith
authors.affiliation: HealthInsight, Salt Lake City, UT.
authors.forename: Kim
authors.initials: K
authors.lastname: Bateman
authors.affiliation: Internal Medicine, University of Utah School of Medicine ; VA Salt Lake City Health Care System.
authors.forename: Adi V
authors.initials: AV
authors.lastname: Gundlapalli
authors.affiliation: Internal Medicine, University of Utah School of Medicine ; VA Salt Lake City Health Care System.
authors.forename: Matthew
authors.initials: M
authors.lastname: Samore
mesh_terms: D000367:Age Factors; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D001294:Attitude to Health; D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D055991:Health Records, Personal; D006801:Humans; D007407:Interviews as Topic; D018579:Patient Selection; D019035:Rural Health Services / Q000458:organization & administration*; D014589:Utah