User acceptability of blockchain technology for enabling electronic health record exchange

Blockchain systems have been proposed as a solution for exchanging electronic health records (EHR) because they enable data sharing in decentralised networks. This paper aims to analyse the user acceptability of blockchain technology in enabling EHR exchange and to formulate practical implications for increasing user acceptability.

A technology acceptance model [extended Unified Theory of Acceptance and Use of Technology (UTAUT) model] was used as a framework to measure the effects of 13 factors. The authors conducted a survey and analysed data from 214 participants using partial least square path modelling.

The acceptance of blockchain for EHR sharing is positively influenced by performance expectancy, social influence and perceived trust. Effort expectancy and facilitating conditions do not influence acceptance. The UTAUT model explains the variance in acceptance at 58.4%. Self-efficacy influences effort expectancy, incentives influence facilitating conditions and security predicts perceived trust.

Three implications are drawn: (1) Users need to clearly understand system’s purpose, functions, security mechanism and environmental impacts. (2) Users are incentivised to share health data via a blockchain solution if the technology offers personalising options and health information. (3) Health personnel can socially impact patients to use blockchain-based solutions.

Studies have shown that blockchain technology is a valuable solution for exchanging EHR. The novelty of this work is to identify how and why patients may accept this emerging technology for EHR exchange.