Value perceptions and implementation priorities for public PHR adoption in Taiwan: an importance–performance analysis with the Chuchiming Index

Abstract Background Value perceptions of personal health record (PHR) components at the pre-adoption stage remain underexplored, despite their critical role in promoting the adoption of public PHRs. Importance–Performance Analysis (IPA) may have limitations in identifying priority issues due to skewed distributions of evaluations. Objective To quantitatively assess citizens’ value perceptions of public PHR platform components using IPA according to usage experience and to evaluate the utility of the Chuchiming Index (ChI) as a complement to IPA. Methods A cross-sectional study was conducted among internet-using citizens. After viewing a video introducing an artificial intelligence (AI)-powered extended PHR platform concept, participants rated the importance and acceptance of platform functions and system design and security components. Participants were grouped by their experience using an existing public PHR platform, and quadrant analysis was conducted using IPA, with ChI used to quantify improvement priorities. Stratified IPA analyses were conducted by age and income, which were identified as factors associated with the use of existing public PHR platforms. Results A total of 177 participants were included in the analysis. All components showed high importance and acceptance regardless of usage experience. Among nonusers, medical record display, wearable data integration, and platform integration fell into Quadrant II, all with positive ChI values. Among users, no items fell into Quadrant II; however, platform integration showed a high ChI value. For system design and security, privacy and security assurance showed the highest ChI values in both groups. Stratified analyses showed marked differences in value perceptions by usage experience among older adults and middle-income groups. Conclusion Value perceptions of individual public PHR platform components differed by usage experience and sociodemographic characteristics. Promoting public PHR adoption requires optimizing strategies that encompass platform design, system implementation, and user uptake according to the needs of different population groups. The ChI complements IPA by enhancing the identification and interpretation of priorities, even under ceiling effects common in public service evaluations. These findings contribute to decision-making regarding the design and implementation strategies of public PHR platforms.