Barriers and facilitators of personal health record adoption in Indonesia: Health facilities' perspectives

Nabila Clydea Harahap; Putu Wuri Handayani; Achmad Nizar Hidayanto

doi:10.1016/j.ijmedinf.2022.104750

Barriers and facilitators of personal health record adoption in Indonesia: Health facilities' perspectives

Int J Med Inform. 2022 Mar 22:162:104750. doi: 10.1016/j.ijmedinf.2022.104750. Online ahead of print.

Authors

Nabila Clydea Harahap¹, Putu Wuri Handayani², Achmad Nizar Hidayanto³

Affiliations

¹ Faculty of Computer Science, University of Indonesia, Depok 16424, Indonesia. Electronic address: nabila.clydea@ui.ac.id.
² Faculty of Computer Science, University of Indonesia, Depok 16424, Indonesia. Electronic address: putu.wuri@cs.ui.ac.id.
³ Faculty of Computer Science, University of Indonesia, Depok 16424, Indonesia. Electronic address: nizar@cs.ui.ac.id.

PMID: 35339888
DOI: 10.1016/j.ijmedinf.2022.104750

Abstract

Background: Personal health record (PHR) has been extensively used in developed countries; however, it has been limitedly adopted in developing countries. This study was conducted in Indonesia: a developing country with the largest population in Southeast Asia. PHR that is integrated with health providers is needed to achieve a transformation from a health provider-centered to a patient-centered healthcare system.

Objective: To qualitatively analyze barriers and facilitators of PHR adoption by health facilities in Indonesia from the technological, organizational, environmental, and individual factors.

Methods: In this qualitative study, we used semi-structured interviews with three health facility directors, 17 IT heads, eight physicians, and three nurses from 10 primary healthcare facilities, nine government hospitals, and six private hospitals in Indonesia. Interview data were analyzed using thematic analysis in NVivo 12. The analysis stages involved familiarizing data, generating initial codes, searching themes, evaluating themes, defining and naming themes, and writing reports.

Results: Regarding technological factors, the barriers to PHR adoption include security and privacy, interoperability, and infrastructure. Organizational support can facilitate PHR adoption in terms of organizational factors, while a lack of human resources is a barrier to PHR adoption. Regarding environmental factors, the lack of government regulations is the barrier to PHR adoption, while competition between health facilities and vendor support could facilitate PHR adoption. Finally, regarding individual factors, perceived usefulness and ease of use can be facilitators of PHR adoption, while user attitudes and e-health literacy can be barriers to PHR adoption.

Conclusions: This study is expected to comprehensively understand PHR adoption in Indonesia and could be applied to other developing countries with similar technological, legal, or cultural characteristics as Indonesia. This study also provides information that can guide health regulators, health facilities, or PHR vendors in planning the implementation of integrated PHR.

Keywords: Adoption; Indonesia; Personal health record; Qualitative study.