Introduction
Electronic Personal Health Records (ePHRs) are secure internet-based systems that allow patients to view parts of their medical records and share them with trusted others [1]. Such systems may also provide services to patients such as messaging healthcare providers, requesting repeat prescriptions, and booking appointments [2].
Despite the potential benefits of ePHRs, their adoption rates are often very low [[2], [3], [4], [5], [6]]. For example, three American national surveys conducted by California HealthCare Foundation [7], Markle Foundation [8], and Markle Foundation [9] reported that about 7%, 3%, and 10% of adults had ever utilised ePHRs, respectively. In the United Kingdom, the adoption rate of ePHRs (i.e. HealthSpace) did not exceed 0.13% [10]. The uptake rates of ePHRs in other Europe countries (e.g. France, Denmark, Estonia, etc.) reached only around 5% [11].
The lack of use of ePHRs among patients leads to a failure of the implementation of these systems [12,13]. Identifying factors that influence patients’ use of ePHRs is crucial to increasing patients’ adoption and improving implementation success of ePHRs [4,5,14]. Many studies have investigated factors that affect patients’ use of ePHRs. To date, no meaningful synthesis of findings has been produced. Therefore, the current study aimed to systematically review the evidence regarding factors that influence patients’ use of ePHRs.
A conceptual framework used by Or and Karsh [15] in a review of consumer health information technology acceptance was used in this review as a theoretical lens to group factors. Or and Karsh adopted this framework from other frameworks developed by Holden and Karsh [16] and Karsh [17]. According to this framework, adoption of health information technologies is predicted by: (i) individual factors, which refer to sociodemographic characteristics, personality characters, and health status; (ii) human-technology interaction factors, which refer to individual’s perceptions and expectations about a technology; (iii) organisational factors, which refer to facilitating conditions provided by organisations, implementation processes, organisation’s structures, and end-user perceptions of them; (iv) social factors, which refer to the effect of other people to which a person belongs; (v) environmental factors, which refer to characteristics of the physical setting where a system is used; and (vi) task factors, which refer to the degree to which a technology influences a task and individual’s perceptions of this effect [15].