Adoption of Electronic Personal Health Records in Canada: Perceptions of Stakeholders.
Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs) because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption.



Using a qualitative descriptive study design, we conducted semi-structured phone interviews between October 2013 and February 2014 with 35 individuals from seven Canadian provinces. The participants represented six stakeholder groups (patients, ePHR administrators, healthcare professionals, organizations interested in health technology development, government agencies, and researchers). A detailed summary of each interview was created and thematic analysis was conducted.



We observed that there was no consensual definition of ePHR in Canada. Factors that could influence ePHR adoption were related to knowledge (confusion with other electronic medical records [EMRs] and lack of awareness), system design (usability and relevance), user capacities and attitudes (patient health literacy, education and interest, support for professionals), environmental factors (government commitment, targeted populations) and legal and ethical issues (information control and custody, confidentiality, privacy and security).



ePHRs are slowly entering the Canadian healthcare landscape but provinces do not seem well-prepared for the implementation of this type of record. Guidance is needed on critical issues regarding ePHRs, such as ePHR definition, data ownership, access to information and interoperability with other electronic health records (EHRs). Better guidance on these issues would provide a greater awareness of ePHRs and inform stakeholders including clinicians, decision-makers, patients and the public. In turn, it may facilitate their adoption in the country.
Faculty of Nursing Science, Université Laval, Quebec City, QC, Canada.|DeGroote School of Business, McMaster University, Hamilton, ON, Canada.|Research Centre of the CHU de Québec-Université Laval, Quebec City, QC, Canada.
Marie-Pierre
MP
Gagnon
DeGroote School of Business, McMaster University, Hamilton, ON, Canada.
Julie
J
Payne-Gagnon
Centre de recherche sur les soins et les services de première ligne, Centre intégré de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada.
Erik
E
Breton
Research Centre of the CHU de Québec-Université Laval, Quebec City, QC, Canada.
Jean-Paul
JP
Fortin
Faculty of Medicine, Université Laval, Quebec City, QC, Canada.
Lara
L
Khoury
Faculty of Law, McGill University, Montreal, QC, Canada.
Lisa
L
Dolovich
Faculty of Law, McGill University, Montreal, QC, Canada.
David
D
Price
Department of Family Medicine, McMaster University, Hamilton, ON, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
David
D
Wiljer
Centre for Addiction and Mental Health, Toronto, ON, Canada.
Gillian
G
Bartlett
Department of Family Medicine, McGill University, Montreal, QC, Canada.
Norman
N
Archer
D001291:Attitude of Health Personnel; D020811:Biomedical Technology; D002170:Canada; D057286:Electronic Health Records; D005260:Female; D006077:Government Agencies / Q000706:statistics & numerical data; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008497:Medical Record Administrators / Q000706:statistics & numerical data; D036301:Qualitative Research; D012108:Research Personnel / Q000706:statistics & numerical data
Adoption; Canada; Electronic Personal Health Record (ePHR); Qualitative Research
J Med Internet Res. 2012 Nov 05;14(6):e150
23128775
J Pediatr. 2013 Jul;163(1):280-1.e1-2
23541773
Arch Intern Med. 2011 Mar 28;171(6):568-74
21444847
J Am Med Inform Assoc. 2011 Dec;18 Suppl 1:i8-12
22071530
J Med Internet Res. 2012 Aug 23;14(4):e114
22917868
CMAJ. 2011 Mar 22;183(5):E281-8
21343262
Health Informatics J. 2011 Mar;17(1):63-71
25133771
Ann Intern Med. 2013 Nov 19;159(10):677-87
24247673
J Med Internet Res. 2008 Oct 31;10(4):e34
18974036
Fam Med. 2011 May;43(5):351-4
21557106
J Am Med Inform Assoc. 2011 Jul-Aug;18(4):515-22
21672914
J Neurooncol. 2014 Mar;117(1):1-6
24477621
Stud Health Technol Inform. 2012;178:39-44
22797017
Curr Oncol. 2013 Dec;20(6):e561-9
24311957
J AHIMA. 2013 Apr;84(4):22-8; quiz 29
23781600
J Clin Oncol. 2012 Dec 1;30(34):4243-8
23071233
Int J Technol Assess Health Care. 2015 Jan;31(1-2):68-77
25952585
BMC Med Inform Decis Mak. 2008 Jul 24;8:33
18652695
JMIR Res Protoc. 2013 Jan 22;2(1):e8
23612564
Health Inf Manag. 2011;40(2):6-14
21712556
Healthc Q. 2008;11(1):92-6
18326386
J Biomed Inform. 2010 Oct;43(5 Suppl):S51-S55
20937485
CMAJ. 2010 Jul 13;182(10):E431-2
20513785
BMJ Open. 2014 Sep 08;4(9):e006021
25200561