Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study

BackgroundDuring the COVID-19 pandemic, personal health records (PHRs) have enabled patients to monitor and manage their medical data without visiting hospitals and, consequently, minimize their infection risk. Taiwan’s National Health Insurance Administration (NHIA) launched...

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Main Authors: Chinyang Henry Tseng, Ray-Jade Chen, Shang-Yu Tsai, Tsung-Ren Wu, Woei-Jiunn Tsaur, Hung-Wen Chiu, Cheng-Yi Yang, Yu-Sheng Lo
Format: Article
Language:English
Published: JMIR Publications 2022-01-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2022/1/e33399
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author Chinyang Henry Tseng
Ray-Jade Chen
Shang-Yu Tsai
Tsung-Ren Wu
Woei-Jiunn Tsaur
Hung-Wen Chiu
Cheng-Yi Yang
Yu-Sheng Lo
author_facet Chinyang Henry Tseng
Ray-Jade Chen
Shang-Yu Tsai
Tsung-Ren Wu
Woei-Jiunn Tsaur
Hung-Wen Chiu
Cheng-Yi Yang
Yu-Sheng Lo
author_sort Chinyang Henry Tseng
collection DOAJ
description BackgroundDuring the COVID-19 pandemic, personal health records (PHRs) have enabled patients to monitor and manage their medical data without visiting hospitals and, consequently, minimize their infection risk. Taiwan’s National Health Insurance Administration (NHIA) launched the My Health Bank (MHB) service, a national PHR system through which insured individuals to access their cross-hospital medical data. Furthermore, in 2019, the NHIA released the MHB software development kit (SDK), which enables development of mobile apps with which insured individuals can retrieve their MHB data. However, the NHIA MHB service has its limitations, and the participation rate among insured individuals is low. ObjectiveWe aimed to integrate the MHB SDK with our developed blockchain-enabled PHR mobile app, which enables patients to access, store, and manage their cross-hospital PHR data. We also collected and analyzed the app’s log data to examine patients’ MHB use during the COVID-19 pandemic. MethodsWe integrated our existing blockchain-enabled mobile app with the MHB SDK to enable NHIA MHB data retrieval. The app utilizes blockchain technology to encrypt the downloaded NHIA MHB data. Existing and new indexes can be synchronized between the app and blockchain nodes, and high security can be achieved for PHR management. Finally, we analyzed the app’s access logs to compare patients’ activities during high and low COVID-19 infection periods. ResultsWe successfully integrated the MHB SDK into our mobile app, thereby enabling patients to retrieve their cross-hospital medical data, particularly those related to COVID-19 rapid and polymerase chain reaction testing and vaccination information and progress. We retrospectively collected the app’s log data for the period of July 2019 to June 2021. From January 2020, the preliminary results revealed a steady increase in the number of people who applied to create a blockchain account for access to their medical data and the number of app subscribers among patients who visited the outpatient department (OPD) and emergency department (ED). Notably, for patients who visited the OPD and ED, the peak proportions with respect to the use of the app for OPD and ED notes and laboratory test results also increased year by year. The highest proportions were 52.40% for ED notes in June 2021, 88.10% for ED laboratory test reports in May 2021, 34.61% for OPD notes in June 2021, and 41.87% for OPD laboratory test reports in June 2021. These peaks coincided with Taiwan’s local COVID-19 outbreak lasting from May to June 2021. ConclusionsThis study developed a blockchain-enabled mobile app, which can periodically retrieve and integrate PHRs from the NHIA MHB's cross-hospital data and the investigated hospital's self-pay medical data. Analysis of users’ access logs revealed that the COVID-19 pandemic substantially increased individuals’ use of PHRs and their health awareness with respect to COVID-19 prevention.
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spelling doaj.art-34da668739fa47ff947a023cdc6283232023-08-28T20:18:44ZengJMIR PublicationsJournal of Medical Internet Research1438-88712022-01-01241e3339910.2196/33399Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability StudyChinyang Henry Tsenghttps://orcid.org/0000-0002-5403-0665Ray-Jade Chenhttps://orcid.org/0000-0002-4666-6364Shang-Yu Tsaihttps://orcid.org/0000-0003-3489-8894Tsung-Ren Wuhttps://orcid.org/0000-0001-5421-0394Woei-Jiunn Tsaurhttps://orcid.org/0000-0002-4247-914XHung-Wen Chiuhttps://orcid.org/0000-0001-6919-8199Cheng-Yi Yanghttps://orcid.org/0000-0002-7407-0074Yu-Sheng Lohttps://orcid.org/0000-0002-6915-509X BackgroundDuring the COVID-19 pandemic, personal health records (PHRs) have enabled patients to monitor and manage their medical data without visiting hospitals and, consequently, minimize their infection risk. Taiwan’s National Health Insurance Administration (NHIA) launched the My Health Bank (MHB) service, a national PHR system through which insured individuals to access their cross-hospital medical data. Furthermore, in 2019, the NHIA released the MHB software development kit (SDK), which enables development of mobile apps with which insured individuals can retrieve their MHB data. However, the NHIA MHB service has its limitations, and the participation rate among insured individuals is low. ObjectiveWe aimed to integrate the MHB SDK with our developed blockchain-enabled PHR mobile app, which enables patients to access, store, and manage their cross-hospital PHR data. We also collected and analyzed the app’s log data to examine patients’ MHB use during the COVID-19 pandemic. MethodsWe integrated our existing blockchain-enabled mobile app with the MHB SDK to enable NHIA MHB data retrieval. The app utilizes blockchain technology to encrypt the downloaded NHIA MHB data. Existing and new indexes can be synchronized between the app and blockchain nodes, and high security can be achieved for PHR management. Finally, we analyzed the app’s access logs to compare patients’ activities during high and low COVID-19 infection periods. ResultsWe successfully integrated the MHB SDK into our mobile app, thereby enabling patients to retrieve their cross-hospital medical data, particularly those related to COVID-19 rapid and polymerase chain reaction testing and vaccination information and progress. We retrospectively collected the app’s log data for the period of July 2019 to June 2021. From January 2020, the preliminary results revealed a steady increase in the number of people who applied to create a blockchain account for access to their medical data and the number of app subscribers among patients who visited the outpatient department (OPD) and emergency department (ED). Notably, for patients who visited the OPD and ED, the peak proportions with respect to the use of the app for OPD and ED notes and laboratory test results also increased year by year. The highest proportions were 52.40% for ED notes in June 2021, 88.10% for ED laboratory test reports in May 2021, 34.61% for OPD notes in June 2021, and 41.87% for OPD laboratory test reports in June 2021. These peaks coincided with Taiwan’s local COVID-19 outbreak lasting from May to June 2021. ConclusionsThis study developed a blockchain-enabled mobile app, which can periodically retrieve and integrate PHRs from the NHIA MHB's cross-hospital data and the investigated hospital's self-pay medical data. Analysis of users’ access logs revealed that the COVID-19 pandemic substantially increased individuals’ use of PHRs and their health awareness with respect to COVID-19 prevention.https://www.jmir.org/2022/1/e33399
spellingShingle Chinyang Henry Tseng
Ray-Jade Chen
Shang-Yu Tsai
Tsung-Ren Wu
Woei-Jiunn Tsaur
Hung-Wen Chiu
Cheng-Yi Yang
Yu-Sheng Lo
Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study
Journal of Medical Internet Research
title Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study
title_full Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study
title_fullStr Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study
title_full_unstemmed Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study
title_short Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study
title_sort exploring the covid 19 pandemic as a catalyst for behavior change among patient health record app users in taiwan development and usability study
url https://www.jmir.org/2022/1/e33399
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