How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France
Abstract Background Electronic health records (EHR) are becoming an integral part of the health system in many developed countries, though implementations and settings vary across countries. Some countries have adopted an opt-out policy, in which patients are enrolled in the EHR system following a d...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-024-10929-w |
| _version_ | 1797209503090868224 |
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| author | Anna Griesser Manel Mzoughi Sonja Bidmon Emna Cherif |
| author_facet | Anna Griesser Manel Mzoughi Sonja Bidmon Emna Cherif |
| author_sort | Anna Griesser |
| collection | DOAJ |
| description | Abstract Background Electronic health records (EHR) are becoming an integral part of the health system in many developed countries, though implementations and settings vary across countries. Some countries have adopted an opt-out policy, in which patients are enrolled in the EHR system following a default nudge, while others have applied an opt-in policy, where patients have to take action to opt into the system. While opt-in systems may exhibit lower levels of active user requests for access, this contrasts with opt-out systems where a notable percentage of users may passively retain access. Thus, our research endeavor aims to explore facilitators and barriers that contribute to explaining EHR usage (i.e., actively accessing the EHR system) in two countries with either an opt-in or opt-out setting, exemplified by France and Austria. Methods A qualitative exploratory approach using a semi-structured interview guideline was undertaken in both countries: 1) In Austria, with four homogenously composed group discussions, and 2) in France, with 19 single patient interviews. The data were collected from October 2020 to January 2021. Results Influencing factors were categorized into twelve subcategories. Patients have similar experiences in both countries with regard to all facilitating categories, for instance, the role of health providers, awareness of EHR and social norms. However, we highlighted important differences between the two systems regarding hurdles impeding EHR usage, namely, a lack of communication as well as transparency or information security about EHR. Conclusion Implementing additional safeguards to enhance privacy protection and supporting patients to improve their digital ability may help to diminish the perception of EHR-induced barriers and improve patients’ health and commitment in the long term. Practical implications Understanding the differences and similarities will help to develop practical implications to tackle the problem of low EHR usage rates in the long run. This problem is prevalent in countries with both types of EHR default settings. |
| first_indexed | 2024-04-24T09:55:44Z |
| format | Article |
| id | doaj.art-cb2e442bd086447c8651db5f647ad1c5 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-24T09:55:44Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-cb2e442bd086447c8651db5f647ad1c52024-04-14T11:11:19ZengBMCBMC Health Services Research1472-69632024-04-0124111610.1186/s12913-024-10929-wHow do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and FranceAnna Griesser0Manel Mzoughi1Sonja Bidmon2Emna Cherif3Department of Marketing and International Management, University of KlagenfurtICD Business School – LARA, Management DepartmentDepartment of Marketing and International Management, University of KlagenfurtUniversity Clermont Auvergne, IAE Clermont Auvergne School of Management - CleRMa, Research Chair “Health and Territories”Abstract Background Electronic health records (EHR) are becoming an integral part of the health system in many developed countries, though implementations and settings vary across countries. Some countries have adopted an opt-out policy, in which patients are enrolled in the EHR system following a default nudge, while others have applied an opt-in policy, where patients have to take action to opt into the system. While opt-in systems may exhibit lower levels of active user requests for access, this contrasts with opt-out systems where a notable percentage of users may passively retain access. Thus, our research endeavor aims to explore facilitators and barriers that contribute to explaining EHR usage (i.e., actively accessing the EHR system) in two countries with either an opt-in or opt-out setting, exemplified by France and Austria. Methods A qualitative exploratory approach using a semi-structured interview guideline was undertaken in both countries: 1) In Austria, with four homogenously composed group discussions, and 2) in France, with 19 single patient interviews. The data were collected from October 2020 to January 2021. Results Influencing factors were categorized into twelve subcategories. Patients have similar experiences in both countries with regard to all facilitating categories, for instance, the role of health providers, awareness of EHR and social norms. However, we highlighted important differences between the two systems regarding hurdles impeding EHR usage, namely, a lack of communication as well as transparency or information security about EHR. Conclusion Implementing additional safeguards to enhance privacy protection and supporting patients to improve their digital ability may help to diminish the perception of EHR-induced barriers and improve patients’ health and commitment in the long term. Practical implications Understanding the differences and similarities will help to develop practical implications to tackle the problem of low EHR usage rates in the long run. This problem is prevalent in countries with both types of EHR default settings.https://doi.org/10.1186/s12913-024-10929-wElectronic health recordOpt-in and opt-out nudgeBarriersFacilitatorsQualitative studyAustria |
| spellingShingle | Anna Griesser Manel Mzoughi Sonja Bidmon Emna Cherif How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France BMC Health Services Research Electronic health record Opt-in and opt-out nudge Barriers Facilitators Qualitative study Austria |
| title | How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France |
| title_full | How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France |
| title_fullStr | How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France |
| title_full_unstemmed | How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France |
| title_short | How do opt-in versus opt-out settings nudge patients toward electronic health record adoption? An exploratory study of facilitators and barriers in Austria and France |
| title_sort | how do opt in versus opt out settings nudge patients toward electronic health record adoption an exploratory study of facilitators and barriers in austria and france |
| topic | Electronic health record Opt-in and opt-out nudge Barriers Facilitators Qualitative study Austria |
| url | https://doi.org/10.1186/s12913-024-10929-w |
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