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Sustaining Patient Portal Continuous Use Intention and Enhancing Deep Structure Usage: Cognitive Dissonance Effects of Health Professional Encouragement and Security Concerns

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Abstract

Sustaining patient portal use is a major problem for many healthcare organizations and providers. If this problem can be successfully addressed, it could have a positive impact on various stakeholders. Through the lens of cognitive dissonance theory, this study investigates the role of health professional encouragement as well as patients’ security concerns in influencing continuous use intention and deep structure usage among users of a patient portal. The analysis of data collected from 177 patients at a major medical center in the Midwestern region of the United States shows that health professional encouragement helps increase the continuous use intention and deep structure usage of the patient portal, while security concerns impede them. Interestingly, health professional encouragement not only has a direct positive influence on continuous use intention and deep structure usage but also lowers the negative impact of security concerns on them. The research model explains a substantial variance in continuous use intention (i.e., 40%) and deep structure usage (i.e., 32%). The paper provides theoretical implications as well as practical implications to healthcare managers and providers to improve patient portal deep structure usage and sustained use for user retention.

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Authors and Affiliations

  1. Information Systems Department, University of Texas Rio Grande Valley, Edinburg, TX, USA

    Murad Moqbel

  2. Health Information Management Department, Texas State University, San Marcos, TX, USA

    Barbara Hewitt

  3. Department of Business and Information Technology, Missouri University of Science and Technology, Rolla, MO, USA

    Fiona Fui-Hoon Nah

  4. Department of Health Information Management, University of Kansas Medical Center, Kansas City, KS, USA

    Rosann M. McLean

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  1. Murad Moqbel
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Correspondence to Murad Moqbel.

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Appendix 1 Measurement instrument

Appendix 1 Measurement instrument

Construct

Items

Source

Health Professional Encouragement

Usage of MyChart is encouraged by my healthcare professional team (e.g., healthcare provider/doctor, office staff, practice administrators).

Zhou and George (2001)

My healthcare professional team endorses MyChart usage.

My healthcare professional team supports involvement in MyChart usage.

Security Concerns

I am concerned about submitting information on MyChart because of the potential for security breaches.

Dinev and Hart (2006)

I am concerned that information on MyChart could be accessed by unauthorized parties who hack into the system.

I am concerned about submitting information on MyChart because others might hack into the system.

Continuous Use Intention

I intend to continue using MyChart in the future.

Kock et al. (2016); Lowry et al. (2015)

I will always try to use MyChart in my daily life.

I plan to continue to use MyChart frequently.

Deep Structure Usage

When I was using MyChart, I used features that helped me to see my lab results.

Burton-Jones and Straub Jr. (2006)

When I was using MyChart, I used features that helped me to request a refill.

When I was using MyChart, I used features that helped me to send a message to my provider.

When I was using my MyChart, I used features that helped me to track my health progress over time.

When I was using my MyChart, I used features that helped me to learn more about my medical condition.

When I was using my MyChart, I used features that helped me to manage my healthcare.

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Moqbel, M., Hewitt, B., Nah, F.FH. et al. Sustaining Patient Portal Continuous Use Intention and Enhancing Deep Structure Usage: Cognitive Dissonance Effects of Health Professional Encouragement and Security Concerns. Inf Syst Front 24, 1483–1496 (2022). https://doi.org/10.1007/s10796-021-10161-5

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