| Description |
In 2003, the Department of Veterans Affairs (VA) introduced My HealtheVet (MHV), an electronic personal health record intended to complement traditional healthcare services. However, most veterans are not using this program. This study generates knowledge as to why this is so. The purpose of this study is to understand the veteran's perspective of the meaning and value of MHV and to see how these perspectives influence their choice to adopt or forego adoption. This study employed a multimethod design, informed by symbolic interactionism and a grounded theory approach to data collection and analysis. A descriptive analysis of an existing VA database compares MHV adopters and nonadopters on key demographic variables. Additionally, analysis of focus group and individual interview data generated categories related to meaning and use and compared the perspectives of adopters and nonadopters. The descriptive analysis identified MHV adopter and nonadopter profiles. Both groups were White, non-Hispanic; the adopter group had an over-representation of females residing in rural areas; the nonadopter group was male living in urban areas. While the demographic characteristics of the groups were different, the differences were relatively small, and the standard residual suggested that the effects of interactions between demographic variables could be more important than single demographic factors. iv The findings from grounded theory coding identified a core category: MHV "eTools," which are functions for logistical and administrative purposes like prescription refills. The content categories linked to eTools indicated the following: veterans did not know about MHV; adopters used MHV on a limited scale (mostly for prescription refills); and providers did not speak of MHV during patient appointments, possibly indicating to the veterans no value in adopting MHV. Based on the findings of this study and the literature review, the key to MHV adoption may be associated with providers' attitudes about MHV. A provider's prescription to use MHV for a particular health purpose may increase a veterans' perceived utility of MHV. The qualitative findings of this study correspond with clinical informatics models such as the Unified Theory on Acceptance and Use of Technology. |
