Using Electronic Medical Records (EMRs) with Chronic Diseases: Trend Analysis Towards Online and Offline Factors Associated with Patient Utilization

Electronic medical records (EMRs) are associated with higher-quality healthcare; however, they also raise concerns about patient information privacy and security. Existing studies have strongly linked these privacy concerns to patients withholding their information, indicating perceived risks with EMRs. Furthermore, studies devoted to EMR usage in hospitals are lacking, particularly those on the EMR system in the contexts of clinical and privacy concerns based on multi-criteria perspectives. The proposed framework is based on how clinical factors and security and privacy determinants influence the use of EMR, utilizing data derived from chronic disease patients in the USA as a frame of reference. In this study, information forage theory is adopted. This research not only objectively analyzes the information privacy aspects of EMRs but also investigates the perceptions of patients with chronic diseases regarding online health information technology and offline patient–provider interactions. These are considered as clinical factors to understand the frequency of EMR adoption across Health Information National Trends Survey (HINTS) data from 2014 ( N = 2,415), 2017 ( N = 2,253), and 2018 ( N = 2,443). The study finds that the rate of information withholding, as a manifestation of information privacy and security concerns, has decreased over the three waves. In contrast, the frequency of EMR usage is found to have continually increased at the three assessment points. Additionally, factors such as confidence in EMR safeguards, electronic medical information maintenance, and the frequency of visiting healthcare providers are significant predictors of EMR utilization over time. The study concludes that addressing online privacy concerns over EMR as part of health information technology and considering offline clinical factors must occur together in order to achieve higher-quality healthcare among patients with chronic diseases and to transform the healthcare system overall.