US adults’ willingness to use a blockchain-based health information management application: A structural equation modeling approach

Background MediLinker is a blockchain-based application for identity verification and personal health information management. To prepare for its clinical deployment, the perceptions of health consumers toward MediLinker should be examined. Objective Guided by a conceptual model derived from the theory of reasoned action, privacy calculus, protection motivation theory, and regulatory uncertainty, the study identifies US adults' willingness to use MediLinker for health information management and the factors associated with this willingness. Methods We conducted a cross-sectional online survey in August 2022 among US adults recruited on Amazon Mechanical Turk. The analytic sample includes data from 913 respondents who nearly reflect US demographic characteristics by gender and race/ethnicity. Descriptive statistics were used to identify respondents' willingness to use MediLinker, while structural equation modeling (SEM) was used to identify direct and indirect factors associated with willingness. Results Most respondents were willing to use MediLinker to store and manage health information (76.7%), share health information with providers (79.3%), and provide consent for clinical research (78.4%). SEM results show that attitude towards MediLinker has a direct positive association with willingness to use MediLinker in general. We also identified several indirect predictors of willingness. For instance, perceived liability issues and perceived vulnerability have a negative indirect effect on willingness through perceived risks and attitude. On the other hand, perceived vulnerability and perceived severity have a positive indirect effect on willingness via perceived benefits and attitude. Conclusion Our sample of US adults is willing to use MediLinker for health information management. Moreover, our conceptual model shows direct and indirect pathways influencing US adults' willingness to use MediLinker. The results inform the deployment of blockchain-based health information management applications among health consumers. Overall, the study contributes to the literature on how healthcare consumers perceive blockchain technologies for medical decision making involving their online health information.